Hemodialysis-associated seizure is a complication of hemodialysis. This report describes the occurrence of seizures in patients with end stage renal disease on dialysis therapy at the Nephrology Institute of Mogi das Cruzes, São Paulo State, Brazil. A retrospective medical history of 189 patients was reviewed to investigate the occurrence of convulsive seizures during dialytic program. Seven patients with history of seizures were selected but five of them were included in our study. Three patients presented generalized tonic-clonic seizures, one had partial seizure with secondary generalization, and one presented unclassified seizure. Three patients presented seizure just during the dialysis (unique seizure) and one of them presented convulsive status epilepticus. The two other patients had already presented seizures prior the beginning of dialysis. We conclude that seizures in renal failure could be considered as occasional events that do not usually become chronic.
-Of the many risk factors suggested for sudden unexpected death in epilepsy (SUDEP), higher frequency of seizures is a very consistent issue. Following this reasoning, it has been established that hemodialysis-associated seizure is a complication of dialysis procedure. Based on these facts, this study investigated a possible association between cardiovascular abnormalities and SUDEP among patients with chronic renal insufficiency in regular hemodialysis program. For that, a retrospective medical history of 209 patients was reviewed to investigate the occurrence of convulsive seizures and EKG abnormalities during dialytic program. Three patients presented generalized tonic-clonic seizures, one had partial seizure with secondary generalization, and one presented unclassified seizure. Any EKG abnormalities and SUDEP event were found in all patients evaluated. In conclusion, the present findings demonstrated uncommon the occurrence of seizures and also SUDEP. Probably, the main justification to not allow us to demonstrated a direct relation between SUDEP and cardiovascular diseases in hemodialysis are the reduced number of cases examined.KEy wOrDS: epilepsy, sudden death, heart, seizure, hemodialysis.Existe algo de especial a respeito das anormalidades cardíacas e morte súbita e inesperada na epilepsia nos pacientes com insuficiência renal crônica no programa regular de hemodiálise?Resumo -Um dos principais fatores de risco para a morte súbita e inesperada na epilepsia (SUDEP) é a alta freqüência de crises epilépticas. Seguindo este raciocínio, tem sido estabelecido que as crises epilépticas associadas à hemodiálise seja uma complicação do procedimento dialítico. Baseado neste fato, este estudo investigou uma possível associação entre anormalidades cardiovasculares e SUDEP nos pacientes com insuficiência renal crônica em um programa regular de hemodiálise. Para isto, um histórico médico retrospectivo de 209 pacientes foi revisado para avaliar a ocorrência de crises epilépticas e possíveis anormalidades no ECG durante o programa de diálise. Três pacientes apresentaram crises tônico-clonica generalizadas, um apresentou crise parcial com generalização secundária e um apresentou crise não-classificada. Não detectamos anormalidades no ECG e ocorrência de SUDEP em todos os pacientes avaliados. Em conclusão, na presente amostra constatou-se como rara a ocorrência de crises epilépticas e SUDEP. Provavelmente, o número reduzido de casos avaliados tenha sido responsável pela não observação de uma relação direta entre SUDEP e as doenças cardiovasculares na hemodiálise.
Epilepsy is the most common acquired chronic neurological disorder; each year about 1 in a 1000 patients with chronic epilepsy die suddenly, unexpectedly, and without explanation, even with postmortem examination (SUDEP). Seizure incidence is approximately 10% in patients with chronic renal failure and hemodialysis-associated seizure has been considered to be a common complication of people on hemodialysis treatment. Considering this, we evaluated the incidence of seizures in 189 patients under dialytic treatment.
OpinionNowadays, we have observed that discoveries in medical sciences have rapidly accelerated and continue to expand. One of the reasons for these positive recent changes is due to the onset of translational research. The term translational research, which was recently incorporated in the dictionary of medical sciences, indicates the integration of the advancements in basic science with clinical trials, taking research from the "bench-to-bedside"1 . This perspective gives rise to a completely new approach to improving health care for people with chronic diseases. Following this line of thought, we currently know that this scientific convergence works very well in several fields 1 , but can still be considered rare among nephrologists and neurologists. Evaluating the field of nephrology, the chronic renal failure, a progressive loss of kidney function that results in permanent kidney failure, is a worldwide public health problem. Furthermore, individuals in this condition need dialysis or a transplanted kidney. Even more problematic than these aspects, renal failure is associated with an increased risk of cardiovascular disease and sudden death 2 . Now, looking through the prism of Neurology, we know that epilepsy is considered the most common serious neurological condition. Unfortunately, each year about one in a 1000 patients with chronic epilepsy will die suddenly, unexpectedly, and without explanation, even with post-mortem examination 3 . Among neurologists around the world, this phenomenon is called sudden unexplained death in epilepsy (SUDEP). In the actual scenario, epilepsy is associated with a two-to three-fold increase in mortality compared to the general population, and SUDEP is the most important direct epilepsy-related cause of death 3 . Thus, as these two chronic diseases are very common in the world and also a global public health problem, a new line of translational research would have great value in helping neurologists and nephrologists to investigate what would be the best strategy to be drawn if these two chronic diseases involve the same individual. From this perspective and mainly due lack of data in the world, our research group decided to investigate the possible relationship between seizure frequencies in patients with end-stage renal disease (ESRD) under regular dialysis program 4 . Briefly, from 189 ESRD patients, 7 had suffered some type of convulsive seizure during dialytic program 4 . At that time, we concluded that despite the occurrence of seizures is considered rare among ESRD individuals receiving dialysis, it should be apparent that a true convergence of clinical nephrology and neurology should always be part of this scenario 4 . The next step for the researchers of our Institute of Nephrology was to verify the possible association between epilepsy and hence SUDEP in these individuals 5 . Overall, we noted in all the cases evaluated (7 out of 209) that cardiovascular abnormalities and hence SUDEP is a rare event in ESRD people with epilepsy receiving dialysis 5 . Although the...
PALAVRAS-CHAVE Elaeis guineenses Elaeis oleífera Palma de óleo REML/BLUP KEYWORDS Elaeis guineenses Elaeis oleíferaOil palm REML/BLUP RESUMO: Híbridos interespecífi cos entre o caiaué e o dendezeiro (HIE OxG) são resistentes ao amarelecimento fatal (AF), principal problema fi tossanitário da dendeicultura. Embora já existam cultivares de HIE OxG recomendadas para o plantio, o melhoramento genético desse tipo de material ainda está em fase inicial, de modo que existe a possibilidade de altos ganhos com seleção. Neste estudo, foram avaliadas características vegetativas na fase juvenil de 42 progênies de HIE OxG em área de incidência do AF. As progênies foram obtidas a partir de cruzamentos de genitores de caiaué das origens Manicoré, Manicoré x São Bartolomeu e Coari e dendezeiro do tipo pisífera da origem La Mé. Três experimentos com 16 progênies, sendo três comuns aos três experimentos, foram estabelecidos no delineamento blocos casualizados com quatro repetições e 12 plantas por parcela. As avaliações foram realizadas dos 42 aos 79 meses de idade, com periodicidade de 6 a 16 meses. Para todas as características, foi observada baixa variabilidade genética, com valores de coefi ciente de variação genético entre 1,5 e 5,2%. As herdabilidades foram baixas (0,03 a 0,199), com exceção da emissão foliar que foi moderada (0,215). A seleção das cinco melhores progênies, segundo RML/BLUP, promoveria redução de 7,4% na altura da planta, 4,5% no comprimento da ráquis, 5,6% no comprimento da folha, 4,9% no comprimento do folíolo, 5,6% no número de folíolos e ganho de 7,1% na emissão foliar. Os resultados indicam baixa expectativa de ganhos com seleção para características vegetativas nas progênies estudadas. ABSCTRACT: Interspecifi c hybrids between caiaué and oil palm (HIE
The objective of this work was to estimate selection gains for bunch production in hybrids obtained from “caiaué” (Elaeis oleifera) parents from the Manicoré population and oil palm (Elaeis guineensis) parents from the La Mé population, from the third to the eighth year after planting. Thirty-nine full-sibling progenies were evaluated in experiments conducted in a randomized complete block design, with four replicates and 12 plants per plot. The genetic gain estimates were 27.6% for the ten best selected F1 individuals, 13.7% for the four best selected progenies from parents of both sexes, 6.4% for the selected progenies of the five best male parents, 6.0% for the selected progenies of the two best families from male parents, and 4.0% for the selected progenies of the best descendants from male parents. Genetic gains for bunch production can be achieved, in the short term, through selection restricted to male parents, and, in the medium term, through selection of both male and female parents and cloning of F1 individuals.
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