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Veterinarians are placed in a leadership role over various teams, and delivering performance feedback is an essential part of being a good leader. Evaluation of underperforming employees is especially challenging, but it is important to recognize that poor performance almost never resolves without active input and support from the team leader. Although it seems counterintuitive, honest and specific performance evaluations can improve work satisfaction and enhance the relationship between the employee and supervisor. This article provides veterinarians with the tools to structure an evaluation system in their practice that will turn a dreaded task into a mechanism to improve workplace culture and performance.

Chronic inflammation and the underlying cardiovascular comorbidity are still current problems in chronic hemodialysis patients. There are few studies comparing the "dialysis dose" (Kt/V) with the degree of inflammation in the patient. Our main objective was to determine whether there is a relationship between serum C-reactive protein (CRP) levels and the Kt/V using ionic dialysance.

Multicenter cross-sectional study. A total of 536 prevalent chronic hemodialysis patients were included. CRP levels, neutrophil-lymphocyte ratio and platelet-lymphocyte ratio were collected. Kt was obtained by ionic dialysance and urea distribution volume was calculated from the Watson's formula. The sample was divided into 2 groups, taking the median CRP as the cut-off point. Dialysis adequacy obtained in each group was compared. Finally, a logistic regression model was carried out to determine the variables with the greatest influence.

Median CRP was 4.10mg/L (q25-q75 1.67-10) and mean Kt/V was 1.48±0.308. Kt/V was lower in the patients included in the high inflammation group (P=.01). In the multivariate logistic regression, the "high" levels of CRP were directly correlated with the Log neutrophil-lymphocyte ratio (P<.001) and inversely proportional with serum albumin values (P=.014), Kt/V (P=.037) and serum iron (P<.001).

The poorer adequacy in terms of dialysis doses (lower Kt/V values) may contribute to a higher degree of inflammation in chronic hemodialysis patients.

The poorer adequacy in terms of dialysis doses (lower Kt/V values) may contribute to a higher degree of inflammation in chronic hemodialysis patients.

The mortality rate of diabetic patients on dialysis is higher than that of non-diabetic patients. Asymmetric dimethylarginine and inflammation are strong predictors of death in hemodialysis. This study aimed to evaluate asymmetric dimethylarginine and C-reactive protein interaction in predicting mortality in hemodialysis according to the presence or absence of diabetes.

Asymmetric dimethylarginine and C-reactive protein were measured in 202 patients in maintenance hemodialysis assembled from 2011 to 2012 and followed for four years. Effect modification of C-reactive protein on the relationship between asymmetric dimethylarginine and all-cause mortality was investigated dividing the population into four categories according to the median of asymmetric dimethylarginine and C-reactive protein.

Asymmetric dimethylarginine and C-reactive protein levels were similar between diabetics and non-diabetics. Asymmetric dimethylarginine - median IQR μM - (1.95 1.75-2.54 versus 1.03 0.81-1.55 P=0.000) differed in nonh diabetes. Inflammation dramatically increases the risk of death associated with high plasma asymmetric dimethylarginine in hemodialysis.

We developed a survey to obtain information on the monitoring practices of major systemic antifungals for treatment and prevention of serious fungal infection.

The survey included questions relating to methodology and practice and was distributed among 137 colleagues of the Study Group of Medical Mycology (GEMICOMED) from July to December 2019.

Monitoring was routinely carried out by most respondents, mainly for voriconazole, and was more likely used to determine the efficacy of the dose administered and less for minimizing drug toxicity. Most responders did not follow the strategies of voriconazole dosage based on CYP2C19 genotyping. Monitoring of posaconazole, itraconazole, or other azole metabolites was not carried out or scarcely demanded. Most responders rarely used flucytosine in their clinical practice nor did they monitor it. According to the answers given by some responders, monitoring isavuconazole, amphotericin B, caspofungin and fluconazole exposure would be also interesting in daily clinical practice in selected patient populations.

The survey reveals common practices and attitudes towards antifungal monitoring, sometimes not performed as per best recommendations, offering an opportunity for education and research. Appropriate use of therapeutic drug monitoring may be an objective of antifungal stewardship programmes.

The survey reveals common practices and attitudes towards antifungal monitoring, sometimes not performed as per best recommendations, offering an opportunity for education and research. Appropriate use of therapeutic drug monitoring may be an objective of antifungal stewardship programmes.Thyroid hormones (TH) are known to play a critical role in regulating many biological processes including growth and development, energy homeostasis, thermogenesis, lipolysis and metabolism of cholesterol. Severe TH deficiency especially during fetal development results in cretinism, but can also lead to an imbalance in metabolism with, among others, an alteration in body weight composition. Over the past two decades, increasing evidence has shown that certain persistent organic pollutants (POP) can interfere with the endocrine system. These POP referred to as "endocrine disrupting chemicals" are widely present in the environment and populations are exposed globally. Y-27632 molecular weight Moreover, epidemiological studies have shown that a particularly sensitive period is the pre- and postnatal time. Indeed, perinatal exposure to such chemicals could lead to the onset diseases in later life. It is known, that, maternal thyroid hormones are transported by the placenta to the fetus from 6 weeks of gestation and it seems that during the first trimester, and part of the second, the fetus is entirely dependent on maternal TH supply for its development.