A pilot, single-blinded, randomized cross-over trial of cramp reduction with angiotensin II in maintenance patients on hemodialysis (The CRAMP-HD study).

Introduction: Angiotensin II may reduce muscle ischemia during intermittent hemodialysis and thereby decrease the incidence and/or intensity of intradialytic muscle cramps. We aimed to test whether angiotensin II infusion during intermittent hemodialysis is safe, feasible, and effective in the attenuation of muscle cramps.

Methods: We performed a pilot, single-blinded, randomized crossover trial of patients receiving intermittent hemodialysis who frequently experience intradialytic muscle cramps.

Efficacy and safety of guanfacine in hospitalized patients with delirium: A scoping review.

Objective: To assess current evidence regarding guanfacine use in hospitalized patients with delirium.

Introduction: Delirium is a common and important complication of critical illness. Central alpha-2 agonists are often used for symptomatic management.

Severe intensive care unit-acquired hypernatraemia: Prevalence, risk factors, trajectory, management, and outcome.

Background: Severe intensive care unit-acquired hypernatraemia (ICU-AH) is a serious complication of critical illness. However, there is no detailed information on how this condition develops.

Objectives: The objective of this study was to study the prevalence, risk factors, trajectory, management, and outcome of severe ICU-AH (≥155 mmol·L).

Systematic review and meta-analysis of the treatment of hypernatremia in adult hospitalized patients: impact on mortality, morbidity, and treatment-related side effects.

Background: Hypernatremia is relatively common in acutely ill patients and associated with mortality. Guidelines recommend a slow rate of correction (≤ 0.5 mmol/L per hour).

Furosemide with adjunctive acetazolamide vs furosemide only in critically ill patients: A pilot two-center randomized controlled trial.

Purpose: Furosemide is the most commonly used diuretic in intensive care units (ICU). We aimed to evaluate the physiological effects of adjunctive acetazolamide with furosemide on diuresis and the prevention of potential furosemide-induced metabolic alkalosis.

Materials And Methods: We performed a two-center, pilot, open-label, randomized trial.

Severely Hyperammonemic Acute Liver Failure due to Paracetamol Overdose: The Impact of High-Intensity Continuous Renal Replacement Therapy.

Introduction: Paracetamol (acetaminophen)-induced acute liver failure (ALF) with severe hyperammonemia (ammonia >100 µmol⋅L-1) is a life-threatening condition. A strategy based on high-intensity continuous renal replacement therapy (CRRT) without early (up to day seven) transplantation may enable clinicians to safely identify which patients can recover and survive and which patients require transplantation.

Methods: We conducted a single-center, retrospective cohort study of patients with severely hyperammonemic paracetamol-induced ALF.

Perfusate hemoglobin during normothermic liver machine perfusion as biomarker of early allograft dysfunction: A pilot study.

Background: Normothermic machine perfusion (NMP) aims to reduce ischemia-reperfusion injury in donor livers and its clinical manifestation, early allograft dysfunction (EAD) by maintaining perfusion and oxygenation. However, there is limited data on which NMP perfusate biomarkers might be associated with such EAD and the role of perfusate hemoglobin has not been assessed.

Methods: We performed a pilot retrospective analysis of adult donor livers undergoing NMP between 2020 and 2022 at our center.

A Pilot and Feasibility Study of Continuous Cardiac Output and Blood Pressure Monitoring during Intermittent Hemodialysis.

Introduction: Hypotension is common during intermittent hemodialysis (IHD) and may be due to a decreased cardiac index (CI). However, no study has simultaneously and continuously measured CI and mean arterial pressure (MAP) to understand the prevalence, severity, and duration of CI decreases or relate them to MAP, blood volume (BV), and net ultrafiltration (NUF) rate.

Methods: In a prospective, pilot and feasibility investigation, we studied 10 chronic IHD patients.

Relative Blood Volume Monitoring during Continuous Renal Replacement Therapy: A Prospective Observational Study.

Introduction: Hematocrit monitoring during continuous renal replacement therapy (CRRT) allows the continuous estimation of relative blood volume (RBV). This may enable early detection of intravascular volume depletion prior to clinical sequelae. We aimed to investigate the feasibility of extended RBV monitoring and its epidemiology during usual CRRT management by clinicians unaware of RBV.

Carboxyhemoglobin as Potential Biomarker for Cardiac Surgery Associated Acute Kidney Injury.

Objectives: Carboxyhemoglobin (CO-Hb) is a marker of hemolysis and inflammation, both risk factors for cardiac surgery-associated AKI (CSA-AKI). However, the association between CO-Hb and CSA-AKI remains unknown.

Design: A retrospective cohort study.

Heat-Related Illnesses.

There is a growing incidence of heat-related illnesses due to rising global temperatures. Heat-related illnesses range from mild to severe, with heat stroke being the most critical. The wet bulb global temperature index considers humidity and solar intensity; its use is recommended to estimate heat stress on an individual and mitigate risk.

Hormetic Nutrition and Redox Regulation in Gut-Brain Axis Disorders.

The antioxidant and anti-inflammatory effects of hormetic nutrition for enhancing stress resilience and overall human health have received much attention. Recently, the gut-brain axis has attracted prominent interest for preventing and therapeutically impacting neuropathologies and gastrointestinal diseases. Polyphenols and polyphenol-combined nanoparticles in synergy with probiotics have shown to improve gut bioavailability and blood-brain barrier (BBB) permeability, thus inhibiting the oxidative stress, metabolic dysfunction and inflammation linked to gut dysbiosis and ultimately the onset and progression of central nervous system (CNS) disorders.

Microbiota profiling in esophageal diseases: Novel insights into molecular staining and clinical outcomes.

Gut microbiota is recognized nowadays as one of the key players in the development of several gastro-intestinal diseases. The first studies focused mainly on healthy subjects with staining of main bacterial species via culture-based techniques. Subsequently, lots of studies tried to focus on principal esophageal disease enlarged the knowledge on esophageal microbial environment and its role in pathogenesis.

Resilient multi-agent RL: introducing DQ-RTS for distributed environments with data loss.

This paper proposes DQ-RTS, a novel decentralized Multi-Agent Reinforcement Learning algorithm designed to address challenges posed by non-ideal communication and a varying number of agents in distributed environments. DQ-RTS incorporates an optimized communication protocol to mitigate data loss between agents. A comparative analysis between DQ-RTS and its decentralized counterpart Q-RTS, or Q-learning for Real-Time Swarms, demonstrates the superior convergence speed of DQ-RTS, achieving a remarkable speed-up factor ranging from 1.

Redox Modulation of Meniere Disease by Treatment, a Nutritional Mushroom Approach with Neuroprotective Potential.

Background: Meniere's disease (MD) is a cochlear neurodegenerative disease. Hearing loss appears to be triggered by oxidative stress in the ganglion neurons of the inner ear.

Objective: Here, we confirm the variation of markers of oxidative stress and inflammation in patients with Meniere and hypothesize that chronic treatment with Coriolus mushroom helps in the response to oxidative stress and acts on α-synuclein and on NF-kB-mediated inflammatory processes Methods: Markers of oxidative stress and inflammation were evaluated in MD patients with or without Coriolus treatment for 3 or 6 months.

The Impact of Early Positive Studies on the Evolution of Extracorporeal Albumin Dialysis Literature: A Bibliometric Analysis.

Introduction: Liver failure is a life-threatening condition characterized by the accumulation of metabolic toxins. Extracorporeal albumin dialysis (ECAD) has been promoted as a possible therapy.

Methods: We employed bibliometric analysis to scrutinize the conceptual, intellectual, and social structure of the ECAD literature including its co-citation network and thematic analysis to explore its evolution and organization.

Exploring the norepinephrine to angiotensin II conversion ratio in patients with vasodilatory hypotension: A post-hoc analysis of the ARAMIS trial.

Purpose: Angiotensin II is approved for catecholamine-refractory vasodilatory shock but the conversion dose ratio from norepinephrine to angiotensin II remains unclear.

Methods: We conducted a post-hoc analysis of the Acute Renal effects of Angiotensin II Management in Shock (ARAMIS) trial involving patients with vasodilatory hypotension. We determined the norepinephrine equivalent dose immediately prior to angiotensin II initiation and calculated the conversion dose ratio between norepinephrine and angiotensin II.

Cardiac Output Changes during Renal Replacement Therapy: A Scoping Review.

Introduction: Renal replacement therapy (RRT) is associated with hypotension. However, its impact on cardiac output (CO) is less understood. We aimed to describe current knowledge of CO monitoring and changes during RRT.

Renal medullary oxygenation during laparoscopic vs open surgery: the impact of blood pressure management-a pilot randomized controlled trial.

The impact of blood pressure targets and surgical approach (laparoscopic or open) on continuous urinary oxygenation (PuO), a validated surrogate of renal medullary PO, during general surgery, is unclear. We aimed to assess the effects of different blood pressure targets and surgical procedures on PuO. We randomized patients receiving either laparoscopic or open surgery into two mean arterial pressure (MAP) target groups: usual MAP or a high MAP.