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en la actitud hacia la donación de órganos entre los estudiantes de Medicina" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1530 "Ancho" => 2172 "Tamanyo" => 172370 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0685" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Regression line between the logarithmic rates of students in favour and the percentage of students who are aware of the concept of brain death.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Antonio Ríos, Marina Iniesta-Sepúlveda, Pablo Ramírez, Ana Isabel López-Navas" 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true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Does food ingestion during hemodialysis lead to change in hepatic oxygenation?" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "506" "paginaFinal" => "508" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Sojiro Imai, Kiyonori Ito, Susumu Ookawara, Satoshi Kiryu, Miho Iguchi, Hidenori Sanayama, Masafumi Kakei, Kaoru Tabei, Yoshiyuki Morishita" "autores" => array:9 [ 0 => array:3 [ "nombre" => "Sojiro" "apellidos" => "Imai" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "Kiyonori" "apellidos" => "Ito" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:4 [ "nombre" => "Susumu" "apellidos" => "Ookawara" "email" => array:1 [ 0 => "su-ooka@hb.tp1.jp" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 3 => array:3 [ "nombre" => "Satoshi" "apellidos" => "Kiryu" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Miho" "apellidos" => "Iguchi" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "Hidenori" "apellidos" => "Sanayama" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 6 => array:3 [ "nombre" => "Masafumi" "apellidos" => "Kakei" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 7 => array:3 [ "nombre" => "Kaoru" "apellidos" => "Tabei" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 8 => array:3 [ "nombre" => "Yoshiyuki" "apellidos" => "Morishita" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Department of Dialysis, Minami-Uonuma City Hospital, Niigata, Japan" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Division of Nephrology, Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Division of Neurology, Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Department of Internal Medicine, Minami-Uonuma City Hospital, Niigata, Japan" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "La ingestión de alimentos durante la hemodiálisis, ¿produce cambios en la oxigenación hepática?" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2415 "Ancho" => 2500 "Tamanyo" => 210831 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(a) Changes in %ΔBV during hemodialysis. (b) Changes in cerebral and hepatic rSO<span class="elsevierStyleInf">2</span> during hemodialysis. Grey arrow represents the decrease in hepatic rSO<span class="elsevierStyleInf">2</span> associated with food ingestion. (c) Changes in SBP, DBP and HR during hemodialysis. %ΔBV, relative change in blood volume; DBP, diastolic blood pressure; HR, heart rate; rSO<span class="elsevierStyleInf">2</span>, regional oxygen saturation; SBP, systolic blood pressure; UFR, ultrafiltration rate.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Food ingestion during hemodialysis (HD) reportedly decreases relative changes in blood volume (%ΔBV).<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">1</span></a> However, the influence of intradialytic food ingestion on changes in systemic tissue oxygenation remains unclear. Here we report a case of deteriorated hepatic oxygenation with food ingestion during HD despite cerebral oxygenation being well maintained. A 68-year-old woman received HD therapy three times per week due to chronic glomerulonephritis. She usually ate a meal at each HD session, after which intradialytic hypotension (IDH) sometimes occurred. Therefore, in addition to the blood pressure measurement, we monitored the %ΔBV using a BV monitor (Nikkiso, Tokyo, Japan). Furthermore, cerebral and hepatic regional oxygen saturation (rSO<span class="elsevierStyleInf">2</span>) were monitored using an INVOS 5100c oxygen saturation monitor (Covidien Japan, Tokyo, Japan) to investigate the association between changes in tissue oxygenation and food ingestion during HD with her informed consent. She ingested 100<span class="elsevierStyleHsp" style=""></span>g of rice, 200<span class="elsevierStyleHsp" style=""></span>g of side dishes, and 200<span class="elsevierStyleHsp" style=""></span>mL of water between 120<span class="elsevierStyleHsp" style=""></span>min and 150<span class="elsevierStyleHsp" style=""></span>min after HD initiation. During this monitoring session, her blood pressure did not change, while the %ΔBV decreased soon after food ingestion. In addition, prior to the decrease in %ΔBV, the hepatic rSO<span class="elsevierStyleInf">2</span> rapidly decreased in response to food ingestion, whereas the cerebral rSO<span class="elsevierStyleInf">2</span> was maintained until the end of HD (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Intrahepatic circulation consists of two different blood supply, one is from hepatic artery and the other is from portal vein. Oxygen saturation in portal vein was low compared with that in systemic arterial circulation, including hepatic artery.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">2,3</span></a> Hepatic rSO<span class="elsevierStyleInf">2</span> are usually maintained during HD without IDH and food ingestion.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">4</span></a> In addition, the deterioration of hepatic oxygenation would precede IDH onset during HD.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">5</span></a> However, investigations of the influence of intradialytic food ingestion to the change in hepatic oxygenation has been limited. In this case, deterioration of hepatic oxygenation in response to food ingestion during HD were confirmed prior to the decrease in %ΔBV, and there might be possible two reasons to explain these associations. First, in animal experiments, the increase in oxygen consumption in the blood flowing through the intestine was confirmed in response to food ingestion.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">6</span></a> Therefore, portal blood into the liver might decrease the oxygen saturation. Second, portal venous blood flow increased and hepatic artery blood flow decreased after food ingestion,<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">7</span></a> which would be associated with the regulation of a hepatic artery buffer response.<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">8,9</span></a> Because of the increase in portal vein blood flow (low oxygen saturation) and the decrease in hepatic arterial blood flow (high oxygen saturation),<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">7</span></a> hepatic rSO<span class="elsevierStyleInf">2</span> might decrease during HD with food ingestion. In contrast to the deterioration of hepatic oxygenation associated with intradialytic food ingestion, cerebral oxygenation was maintained during HD in this case. This result may be explained by the fact that regulation of the systemic circulation usually prioritizes cerebral blood flow and oxygenation at the expense of blood flow and oxygen supply to other compartments, including hepatic circulation.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">4</span></a> However, precise mechanisms regarding the association between intradialytic food ingestion and changes in systemic tissue oxygenation, including the liver, has not been elucidated and further studies are needed to clarify these associations during HD. Based on our experience, food ingestion during HD was possibly associated with the rapid deterioration of hepatic oxygenation; therefore, changes in hepatic oxygenation with food ingestion during HD should be carefully considered in the clinical setting of HD therapy.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0015" class="elsevierStylePara elsevierViewall">This work was supported by a grant from the <span class="elsevierStyleGrantSponsor" id="gs1">Japanese Association of Dialysis Physicians</span> (JADP Grant <span class="elsevierStyleGrantNumber" refid="gs1">2017-9</span>) and <span class="elsevierStyleGrantSponsor" id="gs2">JSPS KAKENHI</span> under Grant No. <span class="elsevierStyleGrantNumber" refid="gs2">JP20K11534</span> to SO. The funder of this study had no role in the study design, collection, analysis and interpretation, writing, or decision to submit the manuscript for publication.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010"><span class="elsevierStyleBold">Conflict</span> of interest</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflict of interest" ] 2 => array:2 [ "identificador" => "xack732409" "titulo" => "Acknowledgement" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2415 "Ancho" => 2500 "Tamanyo" => 210831 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(a) Changes in %ΔBV during hemodialysis. (b) Changes in cerebral and hepatic rSO<span class="elsevierStyleInf">2</span> during hemodialysis. Grey arrow represents the decrease in hepatic rSO<span class="elsevierStyleInf">2</span> associated with food ingestion. (c) Changes in SBP, DBP and HR during hemodialysis. %ΔBV, relative change in blood volume; DBP, diastolic blood pressure; HR, heart rate; rSO<span class="elsevierStyleInf">2</span>, regional oxygen saturation; SBP, systolic blood pressure; UFR, ultrafiltration rate.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0050" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Significant reduction of the large-vessel blood volume by food intake during hemodialysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Y. 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Year/Month | Html | Total | |
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2024 November | 12 | 12 | 24 |
2024 October | 55 | 43 | 98 |
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2024 August | 60 | 65 | 125 |
2024 July | 44 | 27 | 71 |
2024 June | 53 | 42 | 95 |
2024 May | 46 | 54 | 100 |
2024 April | 56 | 45 | 101 |
2024 March | 38 | 31 | 69 |
2024 February | 31 | 34 | 65 |
2024 January | 27 | 30 | 57 |
2023 December | 29 | 29 | 58 |
2023 November | 75 | 49 | 124 |
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2023 August | 24 | 31 | 55 |
2023 July | 25 | 40 | 65 |
2023 June | 25 | 12 | 37 |
2023 May | 17 | 25 | 42 |
2023 April | 16 | 23 | 39 |
2023 March | 14 | 17 | 31 |
2023 February | 14 | 12 | 26 |
2023 January | 28 | 35 | 63 |
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