Long-term renal function after burn-related acute kidney injury with continuous renal replacement therapy.

Acute kidney injury (AKI) is a common complication of severe burn injury and is associated with significant morbidity and mortality. Continuous Renal Replacement Therapy (CRRT) is the preferred treatment for stage 3 AKI due to severe burn. This retrospective cohort study at a single institution aimed to examine the long-term renal outcomes after discharge of burn survivors who underwent CRRT during their ICU stay between 2012-2021 due to burn-related AKI, hypothesizing a return to baseline renal function in the long term. Among the 31 patients meeting inclusion criteria, 22 survived their burn injuries, resulting in a 29 % mortality rate. No significant disparities were observed in demographics, comorbidities, burn characteristics, or critical care interventions between survivors and non-survivors. Serum creatinine and eGFR values normalized for 91 % of patients at discharge. Impressively, 91 % of survivors demonstrated a return to baseline renal function during long-term (>3 years) follow-up. Furthermore, only 18 % underwent dialysis after discharge, primarily within the first year. Cumulative mortality rates were 18.2 %, 22.7 %, and 31.8 % at 1, 3, and > 3 years after discharge, respectively. Causes of death were primarily non-renal. These results suggest that burn-related AKI with CRRT results in lower rates of conversion to ongoing renal dysfunction compared to general ICU cohorts. Despite limitations, this study contributes vital insights into the underexplored issue of long-term outcomes after dicharge in this patient population.

Members of the CUGBP Elav-like family of RNA-binding proteins are expressed in distinct populations of primary sensory neurons.

Primary sensory dorsal root ganglia (DRG) neurons are diverse, with distinct populations that respond to specific stimuli. Previously, we observed that functionally distinct populations of DRG neurons express mRNA transcript variants with different 3' untranslated regions (3'UTRs). 3'UTRs harbor binding sites for interaction with RNA-binding proteins (RBPs) for transporting mRNAs to subcellular domains, modulating transcript stability, and regulating the rate of translation. In the current study, analysis of publicly available single-cell RNA-sequencing data generated from adult mice revealed that 17 3'UTR-binding RBPs were enriched in specific populations of DRG neurons. This included four members of the CUG triplet repeat (CUGBP) Elav-like family (CELF): CELF2 and CELF4 were enriched in peptidergic, CELF6 in both peptidergic and nonpeptidergic, and CELF3 in tyrosine hydroxylase-expressing neurons. Immunofluorescence studies confirmed that 60% of CELF4+ neurons are small-diameter C fibers and 33% medium-diameter myelinated (likely Aδ) fibers and showed that CELF4 is distributed to peripheral termini. Coexpression analyses using transcriptomic data and immunofluorescence revealed that CELF4 is enriched in nociceptive neurons that express GFRA3, CGRP, and the capsaicin receptor TRPV1. Reanalysis of published transcriptomic data from macaque DRG revealed a highly similar distribution of CELF members, and reanalysis of single-nucleus RNA-sequencing data derived from mouse and rat DRG after sciatic injury revealed differential expression of CELFs in specific populations of sensory neurons. We propose that CELF RBPs may regulate the fate of mRNAs in populations of nociceptors, and may play a role in pain and/or neuronal regeneration following nerve injury.

A inferência da L'arginina no coração de ratas espontaneamente hipertensas (SHR) gestantes e no desenvolvimento fetal / The L'arginine influence over the heart of pregnant spontaneously hipertensive rats (SHR) and their fetal development

Objetivo ­ Investigar os efeitos da L-arginina sobre as adaptações cardíacas em ratas espontaneamente hipertensas (SHR) gestantes e o desenvolvimento fetal, analisar histologicamente o ventrículo esquerdo com ou sem suplementação; avaliar a massa corporal; determinar o peso úmido, comprimento, diâmetro do ventrículo esquerdo (VE) e espessura do septo intraventricular do coração e investigar o número de neonatos. Métodos ­ Foram utilizados 6 ratos machos e 24 ratas fêmeas SHR. As SHR foram divididas em três grupos: 1) Grupo Controle: sem suplementação de L-ARG (1:8); 2) L-ARG 2%: com suplementação de L-ARG (9:16) oferecida na água de beber; 3) L-ARG 4%: com L-ARG (17:24) oferecida na água de beber. A análise histológica foi realizada com coloração hematoxilina e eosina (HE). Resultados ­ Os resultados demonstraram a redução da HVE nos animais tratados. A exposição dos animais a concentrações de L-arginina em 20g/l favoreceu maior número de neonatos. O grupo L-ARG 4% obteve a maior redução do peso corporal. Conclusão ­ Este estudo confirma a importância da dose para se alcançar os efeitos desejados.

Objective ­ Investigate the effects of L-arginine on cardiac adaptations in SHR pregnant women and fetal development; analyze histologically the left ventricle with or without supplementation; assess body mass; determine the wet weight, length, diameter of the left ventricle (LV) and thickness of the interventricular septum of the heart and investigate the number of newborns. Methods ­ 6 male rats and 24 female SHR rats were used. SHR were divided into three groups: 1) Control group: no supplementation of L-Arg (1:8); 2) L-ARG 2%: supplemented with L-ARG (9:16) offered in the drinking water; 3) L-ARG 4%: L-Arg (17:24) provided in the drinking water. Histological analysis was performed with hematoxylin and eosin (HE). Results ­ The results showed a reduction of LVH in the treated animals. Exposure of animals to L-arginine concentration of 20g/l favored a greater number of neonates. L-arg% Group 4 had the highest body weight reduction. Conclusions ­ Results confirm the importance of the dose to achieve the desired effects.

The (near) irrelevance of Daubert to criminal justice and some suggestions for reform.

Daubert v Merrell Dow Pharmaceuticals, Inc should have an extraordinary impact on criminal litigation, because there is rarely a criminal trial that does not rely on some form of expert testimony. In fact, it is almost irrelevant. Despite the frequency of prosecution proffered scientific and expert testimony in criminal cases, Daubert is rarely invoked to challenge it. In civil cases, when expert testimony is challenged in criminal proceedings, the outcome could not be more different. Because most violent crimes are committed by the poor, their court appointed advocates--overworked and under-financed--are not up to the challenge. In the absence of a system of effective representation, Daubert will not improve scientific evidence in criminal cases. The only way to guard against the misapplication of forensic science is to impose controls and reforms long before the cases come to court.