Homopolar linear machines are particularly interesting due to their passive track and could be well adapted for transportation systems. They eliminate the need for permanent magnets used in synchronous motors and exhibit better power factors compared to induction machines. This paper presents the performance and measurement results of a scaled vehicle equipped with a Homopolar Linear Motor and its separate levitation system. Advantages and drawbacks of this system are also discussed and compared with other technologies

BACKGROUNDPatients on maintenance dialysis are at high risk for serious complications from COVID-19 infection, including death. We present an overview of local experience with dialysis unit management and reorganisation, local epidemiology and outcomes during the COVID-19 outbreak in Geneva, Switzerland, where SARS-CoV-2 incidence was one of the highest in Europe.METHODSAll SARS-CoV-2-positive outpatients on maintenance dialysis were transferred from their usual dialysis facility to the Geneva University Hospitals dialysis unit to avoid creation of new clusters of transmission. Within this unit, appropriate mitigation measures were enforced, as suggested by the institutional team for prevention and control of infectious diseases.RESULTSFrom 25 February to 31 December 2020, 82 of 279 patients on maintenance dialysis tested positive for SARS-CoV-2 during two distinct waves, with an incidence rate of 73 cases per 100,000 person-days during the first wave and 342 cases per 100,000 during the second wave, approximately four- to six-fold higher than the general population. The majority of infections (55%) during both waves were traced to clusters. Most infections (62%) occurred in men. Sixteen patients (34%) died from COVID-19 related complications. Deceased patients were older and had a lower body mass index as compared with patients who survived the infection.CONCLUSIONSARS-CoV-2 is associated with high infection and fatality rates in the dialysis population. Strict mitigation measures seemed to be effective in controlling infection spread among patients on maintenance dialysis outside of clusters. Large scale epidemiological studies are needed to assess the efficacy of preventive measures in decreasing infection and mortality rates within the dialysis population.

Renal artery stenosis can lead to renovascular secondary hypertension. It can also induce an elevation of creatinine, but usually in the case of bilateral stenosis. In addition, it may be associated with the occurrence of heart failure and pulmonary edema. In this context, it may seem intuitive to want to dilate this artery to improve clinical outcome, but the data in current literature speak rather against this intervention. We will see that that there are some specific criteria for revascularization, but the procedure is not without risk. We present here a case of unilateral renal artery stenosis whose indication for invasive treatment was relative, exposing the patients to unnecessary risks.

Current protocols recommend an initial assessment of acute kidney injury often extensive, not very useful in the majority of cases. A review of the literature allowed us to propose a management algorithm limiting these investigations integrating a « less is more » approach. The cornerstone of this algorithm is the urinary dipstick, inexpensive and easy to perform, used as a screening test. This examination alone can, in the absence of factors suggestive of a post-renal or renal cause, guide the diagnosis and management.

La photothérapie est un traitement des troubles circadiens veille-sommeil dont les bases physiologiques reposent sur de très nombreux travaux scientifiques concordants.Son efficacité est liée à des critères précis d'intensité, de durée, de moment d'exposition, et de longueur d'onde.La photothérapie est potentiellement indiquée dans les syndromes d'avance et de retard de phase, les rythmes différents de 24 heures (non 24), le travail posté-de nuit, le décalage horaire (jet-lag).Compte tenu de son mode d'action, la photothérapie peut être déconseillée chez les patients présentant certaines pathologies rétiniennes, et l'avis de l'ophtalmologue est recommandé.Phototherapy is one treatment of circadian sleep-wake disorders, which is based on consensual and numerous scientific and clinical evidences.Phototherapy efficiency depends on several light characteristics based on intensity, length of exposure, time of exposure and wavelength.Phototherapy is potentially indicated in the following circadian disorders: advanced sleep-wake phase disorder (ASWPD), delayed sleep-wake phase disorder (DSWPD), non-24-hour sleep-wake rhythm disorder (N24SWD), jet-lag and night-shift work sleep-wake disorders (NSSWD).Phototherapy, acting via the retina, may be avoided in patients with retina disorders, an ophthalmologist should be consulted.

Renal function is usually estimated through the blood measurement of creatinine, which allows estimating the glomerular filtration rate (GFR). However, this value only decreases when half the nephrons are damaged, limiting the detection of early renal disease. The ingestion of an important amount of protein can increase the GFR. The renal functional reserve concept is the difference between the maximal GFR, stimulated by an important protein intake, and the baseline GFR. A diminished renal functional reserve could mean glomerular hyperfiltration and early renal disease. This value could help predicting patients more likely to present with acute renal injury and evaluating the capacity of the kidney to increase their function before a nephrectomy.

The glomerulonephritis (GN) are responsible for a significant amount of end stage renal disease. They may be secondary to another disease or idiopathic. When a secondary etiology has been excluded, it is called primary glomerulonephritis (PGN). Glomerular damage may have different presentations and there are many way to classify them. It is thus difficult for the non-specialist to understand the terminology used. This article is a summary of the most frequently encountered PGN such as: IgA nephropathy, membranous GN, idiopathic nephrotic syndrome, extracapillary and membranoproliferative GN. A brief description is given for each one of the PGN including epidemiology, semiology, histology and a pathophysiology explanation.

The glomerulonephritis (GN) are responsible for a significant amount of end stage renal disease. They may be secondary to another disease or idiopathic. When a secondary etiology has been excluded, it is called primary glomerulonephritis (PGN). Glomerular damage may have different presentations and there are many way to classify them. It is thus difficult for the non-specialist to understand the terminology used. This article is a summary of the most frequently encountered PGN such as: IgA nephropathy, membranous GN, idiopathic nephrotic syndrome, extracapillary and membranoproliferative GN. A brief description is given for each one of the PGN including epidemiology, semiology, histology and a pathophysiology explanation.

Background High-volume haemofiltration (HVHF) has been used successfully in animal models with sepsis, and preliminary data have shown that this technique may improve the haemodynamics in patients with refractory septic shock. We used high-volume continuous venovenous haemodiafiltration (CVVHDF) in patients with acute kidney injury (AKI) and refractory septic shock to evaluate their outcome when compared with their prognosis predicted by scores of severity. Methods This is a cohort study in a Medical and Surgical Intensive Care Unit. Fifty-five patients with refractory septic shock and AKI were included in the study. Results High-volume CVVHDF was started in patients with AKI and septic shock requiring norepinephrine dose >0.2 µg/kg/min. AKI was classified according to the RIFLE criteria. Treatment was implemented within the first 24 h of refractory septic shock with a dialysis dose of 70 mL/kg/h until reversal of shock or death. Fifty-five patients were treated with high-volume CVVHDF with an observed mortality of 63%, similar to the mortality predicted by the APACHE II and SAPS II scores. Conclusion Survival rate in our patients with AKI and refractory septic shock treated with high-volume CVVHDF was identical to survival predicted by the severity scores. Treatment with high-volume haemodiafiltraton is applicable to severely ill patients with septic shock but does not confer any clear advantage in terms of survival. This therapy should not be implemented on a routine basis in patients with AKI and refractory septic shock.

Colonoscopy is a commonly used procedure for colon cancer screening. The ideal bowel preparation for a good visualization of the colonic mucosa would be effective and well tolerated. Sodium phosphate (NaP) and polyethylen glycol (PEG) are the two most frequently used solutions in this indication. However, although NaP has been described as more effective and better tolerated, it can cause severe acute electrolytes disturbances and, in rare cases, lead to irreversible renal failure, called phosphate nephropathy. NaP should therefore be prescribed with caution and be formally banned for patients with risk factors.

Background. Leptospirosis is a spirochetal zoonosis with complex clinical features including renal and liver failure. Case report. We report the case of a Swiss fisherman presenting with leptospirosis. After initial improvement, refractory septic shock and severe liver and kidney failure developed. The expected mortality was estimated at 90% with clinical scores. The patient underwent plasma exchanges and high-volume hemofiltration (HVHF) with complete recovery of hepatic and kidney functions. Discussion. Plasma exchanges and HVHF may confer survival benefit on patients with severe leptospirosis, refractory septic shock, and multiple-organ failure.

Colonoscopy is a commonly used procedure for colon cancer screening. The ideal bowel preparation for a good visualization of the colonic mucosa would be effective and well tolerated. Sodium phosphate (NaP) and polyethylen glycol (PEG) are the two most frequently used solutions in this indication. However, although NaP has been described as more effective and better tolerated, it can cause severe acute electrolytes disturbances and, in rare cases, lead to irreversible renal failure, called phosphate nephropathy. NaP should therefore be prescribed with caution and be formally banned for patients with risk factors.