Raised questions about the proposed adjustment in CKD classification in the elderly.

In a recent review article, authors suggest lowering the diagnostic threshold for chronic kidney disease (CKD) in the elderly population. Here, it is discussed the possible implications of that proposed change.

Renouncement of renal replacement therapy: withdrawal and refusal.

Renouncement of renal replacement therapy (RRT) is a medical dilemma. This review covers the concept, the magnitude, the prognosis, and discusses strategies and management approaches about this subject in patients with CKD and AKI. Evidence suggests that refusal is more frequent and carries a more guarded prognosis than withdrawal of RRT.

Global and cardiovascular mortality and risk factors in patients under hemodialysis treatment.

Background: There is a high global and cardiovascular mortality rate among patients who need hemodialysis.

Objective: To assess global and cardiovascular mortality and to identify the risk factors in patients who undergo hemodialysis.

Methods: Observational, prospective study.

Compliance with inhaled corticosteroid treatment: rates reported by guardians and measured by the pharmacy.

Objective: There is elevated morbidity associated with asthma, particularly in developing countries, and failure to comply with inhaled corticosteroid treatment contributes to this morbidity. The objective of this study is to compare rates of compliance with beclomethasone treatment reported by parents or guardians with those measured by pharmacy dispensing records.

Methods: A concurrent cohort study of 12 months' duration was carried out, enrolling 106 asthmatic children and adolescents, selected at random.

[Adult nesidioblastosis].

In adults, endogenous hyperinsulinemic hypoglycaemia is almost invariably due to insulinoma. The authors describe a 29 year old patient with repeated postprandial symptomatic hypoglycaemias and negative prolonged fast test. Distal pancreatectomy was performed, directed by positive arteriographic testing.

[Prophylactic treatment of asthma].

Objective: To review basic concepts, inhalation therapy, classification of asthma and peculiarities of asthma in developing countries.

Sources: Direct search in the Medline, HighWire and MD Consult databases.

Summary Of The Findings: Inhaled corticosteroids are the drugs of choice for the treatment of asthma.

Creatine supplementation induces alteration in cross-sectional area in skeletal muscle fibers of wistar rats under swimming training.

Creatine has been shown to increase the total muscle mass. In this study, we investigated the effect of oral creatine monohydrate supplementation on cross-sectional area of type I, IIA and IIB fibers of gastrocnemius, extensor digitorum longus - EDL and soleus muscles from male Wistar rats subjected to swimming training for 33 days. Four groups were set up: sedentary with no supplementation (CON), sedentary with creatine supplementation (3.