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Search Results: 1 - 10 of 11420 matches for " Rafael Selgas "
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Tratamiento con ácido tranexámico de la hematuria incoercible en la poliquistosis renal autosómica dominante
Peces,Ramón; Aguilar,Ana; Vega,Cristina; Cuesta,Emilio; Peces,Carlos; Selgas,Rafael;
Nefrología (Madrid) , 2012,
Abstract: background: gross haematuria is a common manifestation of autosomal dominant polycystic kidney disease (adpkd). it can be spontaneous or can result from trauma, renal calculi, tumour, or infection. spontaneous cyst bleeding is important to consider in this particular group of patients, since it can be prolonged by local activation of fibrinolysis by urokinase. the management of haematuria in adpkd is usually conservative, including bed rest, blood transfusion, correction of coagulopathies, and use of ddavp, and erythropoietin stimulating agents. in some patients, the management of gross or life-threatening haematuria may require embolization and/or nephrectomy. nonetheless, other modalities have been tried to avoid prolonged hospitalization and nephrectomy and to preserve kidney function. these include the use of anti-fibrinolytics. tranexamic acid was recently suggested as a tool to treat gross haematuria in adpkd, in single isolated cases. objective: the aim of this study was to evaluate prospectively the response to tranexamic acid administration in a group of 8 patients with adpkd and gross haematuria unresponsive to conventional treatment. results: the massive bleeding promptly stopped within 2 to 5 days in all patients. the haemoglobin level and renal function subsequently stabilized. there were not side effects including thromboembolic events. in this case series, the largest prospective one study so far published and the only one including different degrees of renal function, tranexamic acid is confirmed as a promising tool for treating haematuria due to intracystic bleeding in adpkd. conclusions: in summary, tranexamic acid can be used safely in some adpkd patients with chronic renal impairment or preserved renal function to treat severe haematuria poorly responsive to conventional therapy. tranexamic acid can be administered orally or iv; and dose adjustment for renal impairment is important. tranexamic acid therapy may preserve renal function in adpkd, di
Are the Mesothelial-to-Mesenchymal Transition, Sclerotic Peritonitis Syndromes, and Encapsulating Peritoneal Sclerosis Part of the Same Process?
Jesús Loureiro,Guadalupe Gónzalez-Mateo,José Jimenez-Heffernan,Rafael Selgas
International Journal of Nephrology , 2013, DOI: 10.1155/2013/263285
Abstract:
On a cross-diffusion segregation problem arising from a model of interacting particles
Gonzalo Galiano,Virginia Selgas
Mathematics , 2013,
Abstract: We prove the existence of solutions of a cross-diffusion parabolic population problem. The system of partial differential equations is deduced as the limit equations satisfied by the densities corresponding to an interacting particles system modeled by stochastic differential equations. According to the values of the diffusion parameters related to the intra and inter-population repulsion intensities, the system may be classified in terms of an associated matrix. For proving the existence of solutions when the matrix is positive definite, we use a fully discrete finite element approximation in a general functional setting. If the matrix is only positive semi-definite, we use a regularization technique based on a related cross-diffusion model under more restrictive functional assumptions. We provide some numerical experiments demonstrating the weak and strong segregation effects corresponding to both types of matrices.
Deterministic particle method approximation of a contact inhibition cross-diffusion problem
Gonzalo Galiano,Virginia Selgas
Mathematics , 2013,
Abstract: We use a deterministic particle method to produce numerical approximations to the solutions of an evolution cross-diffusion problem for two populations. According to the values of the diffusion parameters related to the intra and inter-population repulsion intensities, the system may be classified in terms of an associated matrix. When the matrix is definite positive, the problem is well posed and the Finite Element approximation produces convergent approximations to the exact solution. A particularly important case arises when the matrix is only positive semi-definite and the initial data are segregated: the contact inhibition problem. In this case, the solutions may be discontinuous and hence the (conforming) Finite Element approximation may exhibit instabilities in the neighborhood of the discontinuity. In this article we deduce the particle method approximation to the general cross-diffusion problem and apply it to the contact inhibition problem. We then provide some numerical experiments comparing the results produced by the Finite Element and the particle method discretizations.
Analysis of a splitting-differentiation population model leading to cross-diffusion
Gonzalo Galiano,Virginia Selgas
Mathematics , 2015,
Abstract: Starting from the dynamical system model capturing the splitting-differentiation process of populations, we extend this notion to show how the speciation mechanism from a single species leads to the consideration of several well known evolution cross-diffusion partial differential equations. Among the different alternatives for the diffusion terms, we study the model introduced by Busenberg and Travis, for which we prove the existence of solutions in the one-dimensional spatial case. Using a direct parabolic regularization technique, we show that the problem is well posed in the space of bounded variation functions, and demonstrate with a simple example that this is the best regularity expected for solutions. We numerically compare our approach to other alternative regularizations previously introduced in the literature, for the particular case of the contact inhibition problem. Simulation experiments indicate that the numerical scheme arising from the approximation introduced in this article outperforms those of the existent models from the stability point of view.
Peritonitis esclerosante encapsulante asociada a la diálisis peritoneal: Una revisión y una iniciativa unitaria europea para abordar el cuidado de una enfermedad rara
De Sousa,Erika; del Peso-Gilsanz,Gloria; Bajo-Rubio,M. Auxiliadora; Ossorio-González,Marta; Selgas-Gutiérrez,Rafael;
Nefrología (Madrid) , 2012, DOI: 10.3265/Nefrologia.pre2012.Jul.11615
Abstract: encapsulating peritoneal sclerosis (eps) represents a rare complication in peritoneal dialysis (pd) with high mortality. it is characterised by diffuse peritoneal membrane fibrosis, which develops into encapsulation and manifests as clinical signs and symptoms of intestinal obstruction. its incidence varies from 0.7%to 3.3%. the most significant risk factor in its development is exposure time to pd solutions, although young age and peritonitis episodes can also contribute. its aetiopathogeny has not been clearly explained and it is thought that a second hit like peritonitis, hemoperitoneum, surgery, genetic predisposition, etc on an already damaged peritoneal membrane, could also trigger the development of eps. some cases appear after transfer to haemodialysis or after transplant. in these cases, the use of calcineurin inhibitors is believed to be related. the presence of clinical symptoms and signs of intestinal obstruction, along with compatible radiological and/or anatomical findings could also confirm the diagnosis. at present there are no clinical or biochemical markers capable of predicting its onset. therapeutic management comprises the use of immunosuppressors like steroids and tamoxifen, nutritional management and even surgery in advanced cases, all of which provide varying results. this article discusses the diagnosis and treatment of eps, it encourages the participation in the european registry and it advocates the need to centralise the management of this medical complication.
Beneficio de la realización de un taller en gestión emocional para enfermería nefrológica
García-Llana,Helena; Barbero Gutiérrez,Javier; Remor Bitencurt,Eduardo; Celadilla Díez,Olga; Trocoli González,Filo; Del Peso Gilsanz,Gloria; Selgas Gutiérrez,Rafael;
Enfermería Nefrológica , 2012, DOI: 10.4321/S2254-28842012000300004
Abstract: nursing professionals in the nephrology service received emotional management training in the form of a 12-hour workshop focused on the relational technology of counselling, which can be widely applied in healthcare environments. the aim was to assess changes in attitudes in relation to bioethical principles and in knowledge of communication and emotional management before and after the implementation of the workshop. the sample was made up of 63 professionals from the nephrology nursing area (43 nurses and 20 auxiliaries) for the knowledge variable and of 23 professionals for the attitudes variable (18 nurses and 5 auxiliaries). the results show changes in engagement with bioethical principles (p<0.05) and knowledge (p<0.001) in the sample.
Are the Mesothelial-to-Mesenchymal Transition, Sclerotic Peritonitis Syndromes, and Encapsulating Peritoneal Sclerosis Part of the Same Process?
Jesús Loureiro,Guadalupe Gónzalez-Mateo,José Jimenez-Heffernan,Rafael Selgas,Manuel López-Cabrera,Abelardo Aguilera Peralta
International Journal of Nephrology , 2013, DOI: 10.1155/2013/263285
Abstract: Mesothelial-to-mesenchymal transition (MMT) is an autoregulated physiological process of tissue repair that in uncontrolled conditions, such as peritoneal dialysis (PD), can lead to peritoneal fibrosis. The maximum expression of sclerotic peritoneal syndromes (SPS) is the encapsulating peritoneal sclerosis (EPS) for which no specific treatment exists. The SPS includes a wide range of peritoneal fibrosis that appears progressively and is considered as a reversible process, while EPS does not. EPS is a serious complication of PD characterized by a progressive intra-abdominal inflammatory process that results in bridles and severe fibrous tissue formation which cover and constrict the viscera. Recent studies show that transdifferentiated mesothelial cells isolated from the PD effluent correlate very well with the clinical events such as the number of hemoperitoneum and peritonitis, as well as with PD function (lower ultrafiltration and high Cr-MTC). In addition, in peritoneal biopsies from PD patients, the MMT correlates very well with anatomical changes (fibrosis and angiogenesis). However, the pathway to reach EPS from SPS has not been fully and completely established. Herein, we present important evidence pointing to the MMT that is present in the initial peritoneal fibrosis stages and it is perpetual over time, with at least theoretical possibility that MMT initiated the fibrosing process to reach EPS. 1. Introduction Peritoneal dialysis (PD) is a form of renal replacement therapy that uses the peritoneal membrane (PM) as semipermeable barrier for the exchange of toxic substances and water. This technique has increased during the last years, in parallel to its complications. Currently, prolonged survival on PD has been reached due to technological advances, prevention, and early diagnosis of uremic complications. The basic objective of DP is the long-term preservation of the PM function. The PM is lined by a monolayer of MCs that have characteristics of epithelial cells and act as a permeability barrier across which ultrafiltration and diffusion take place. The long-term exposure to hyperosmotic, hyperglycaemic, and low pH of dialysis solutions and repeated episodes of peritonitis or hemoperitoneum cause injury of the peritoneum, which progressively becomes denuded of MCs and undergoes fibrosis and neovascularization [1]. Such structural alterations are considered the major cause of ultrafiltration failure [1, 2]. In this context, it has been proposed that local production of vascular endothelial growth factor (VEGF), a potent proangiogenic cytokine,
Estudio Selgascano: Madrid, Espa?a
Selgas,José; Cano,Lucía;
ARQ (Santiago) , 2011, DOI: 10.4067/S0717-69962011000100009
Abstract: far away from hand-made construction but close to industrial production and transfer of technology, this pavilion-studio results from a few dry assembly operations and the unusual combination of several standard parts such as a curved plastic membrane taken from train components. window and ceiling becoming one single element and a half-sunken space blur the objectual condition of the building: it stands barely as a surface.
Estudio Selgascano: Madrid, Espa a
José Selgas,Lucía Cano
ARQ , 2011,
Abstract: Distante de la autoconstrucción artesanal y más cerca de los ámbitos de la producción industrializada y la transferencia tecnológica, la construcción de este estudio se resuelve con escuetas operaciones en seco y la asociación inusual de varios elementos de catálogo como la membrana curvada de plástico, importada desde el listado de componentes de un carro ferroviario. La fusión entre ventana y techo y las decisiones de implantación en el terreno atenúan la cualidad objetual del pabellón: es más bien apenas una superficie. Far away from hand-made construction but close to industrial production and transfer of technology, this pavilion-studio results from a few dry assembly operations and the unusual combination of several standard parts such as a curved plastic membrane taken from train components. Window and ceiling becoming one single element and a half-sunken space blur the objectual condition of the building: it stands barely as a surface.
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