Nefrología : publicación oficial de la Sociedad Española Nefrologia
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Letter Case Reports
[Disseminated tuberculosis with splenic abscesses during haemodialysis].
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Letter Case Reports
[Granulomatous interstitial nephritis in the absence of extrarenal sarcoid].
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Review Meta Analysis
[Exercise in haemodyalisis patients: a literature systematic review].
Exercise as a therapeutic tool used in End-stage renal disease patients (ESRD) in hemodialysis (HD) is not routinately applied, as it occurs with cardiac or respiratory patients. Lack of awareness of research in this field may contribute to the current situation. Thus, the aims of this review are: 1) to systematically review the literature of exercise training on adult HD patients or patients at a pre-HD stage; 2) to show the evidence on the benefits of exercise for counteracting physiological, functional and psychological impairments found even in older ESRD patients; 3) to recommend requirements of future research in order to include exercise prescription in the HD patients treatment. ⋯ Summarizing, moderate evidence exists on the improvement on exercise capacity of aerobic training, isolated or combined with strength training. Strength training improves health related quality of life, functional capacity and lower limbs strength. Future studies should clarify which out of the three modalities results in higher benefits for HD patients.
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In a world undergoing constant change, in the era of globalisation, the training of medical professionals should be under constant review so that it can be tailored to meet the needs of this society in transition. This is all the more true at times of economic uncertainty, such as the current conditions, which have a direct impact on health services. Professionals need new Competencies for new times. ⋯ Accordingly, they should consolidate their teaching and learning structures and the various different educational roles (Director of Studies, Tutors, and other teaching positions), showing the leadership necessary to allow proper implementation of their training programmes. For this, the Spanish Autonomous Regions must develop their own legislation regulating Medical Specialty Training. So, medical professionals should receive training, based on ethical values, behaviours and attitudes that considers humanistic, scientific and technical factors, developing an understanding of the scientific method; ability to put it into practice; skills to manage complexity and uncertainty; a command of scientific, technical and IT terminology to facilitate independent learning; and a capacity for initiative and teamwork, as well as skills for dealing with people and for making an effective, democratic contribution both within health organisations and in the wider society.
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Hemophagocytic Syndrome is a clinical condition characterized by the activation of either macrophages or histiocytes with a prominent hemophagocytosis feature in the bone marrow and other reticuloendothelial systems. It leads to the phagocytosis of erythrocytes, leukocytes, platelets and their precursors. The presence of hemophagocytosis can be associated to infections, malignancies, autoimmune diseases, drugs and a variety of other medical conditions. ⋯ It offers significant differential diagnosis challenges and requires urgent therapeutic intervention. There are only few cases reported in the literature. However, much is still needed in order to better understand its causes, all the immunopathogenic mechanisms, as well as its clinical and therapeutic aspects.