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James Tattersall
Current guidelines focus on conventional dialysis defined as 3-5 hours, three times per week, and suggest that longer or more frequent dialysis be considered. This paper presents the case for considering that shorter or less frequent dialysis should also be considered. More frequent and/or longer dialysis facilitates control of fluid overload, blood pressure, and phosphate levels. These benefits will require time to translate into probable hard outcome improvement. Patients are unlikely to participate in productive or pleasurable activities while undergoing dialysis in center or traveling to treatment...
October 20, 2016: Seminars in Dialysis
Renata Rubinsztajn, Tadeusz Przybyłowski, Marta Maskey-Warzęchowska, Krzysztof Karwat, Ryszarda Chazan
: Body composition disorders are observed in chronic obstructive pulmonary disease (COPD) patients and have a significant impact the general condition and outcome in this disease. AIM: The aim of the study was to assess body composition in relation to airway obstruction severity in patients with COPD. MATERIALS AND METHODS: The study group consisted of 143 patients (58F, 85M) in the middle age The group was divided to two groups: group A FEV1<50% predicted and group B FEV1 ≥50% predicted; both groups were compared...
October 19, 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Andressa S Pinto, Marcio F Chedid, Léa T Guerra, Mario R Álvares-DA-Silva, Alexandre de Araújo, Luciano S Guimarães, Ian Leipnitz, Aljamir D Chedid, Cleber R P Kruel, Tomaz J M Grezzana-Filho, Cleber D P Kruel
Background: Reliable measurement of basal energy expenditure (BEE) in liver transplant (LT) recipients is necessary for adapting energy requirements, improving nutritional status and preventing weight gain. Indirect calorimetry (IC) is the gold standard for measuring BEE. However, BEE may be estimated through alternative methods, including electrical bioimpedance (BI), Harris-Benedict Equation (HBE), and Mifflin-St. Jeor Equation (MSJ) that carry easier applicability and lower cost. Aim: To determine which of the three alternative methods for BEE estimation (HBE, BI and MSJ) would provide most reliable BEE estimation in LT recipients...
July 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Chang Amber Liu, Jinghu Sui, Charles J Coté, Thomas A Anderson
BACKGROUND AND OBJECTIVES: Caudal anesthesia is a common and effective regional anesthesia technique in pediatric patients. The addition of epinephrine to local anesthetics in caudal anesthesia is a frequent practice; however, changes in hemodynamic and cardiac parameters produced by epinephrine in caudal anesthesia are not well studied. Using data collected with the ICON noninvasive cardiac output monitor, we examined the hemodynamic changes associated with the administration of epinephrine containing local anesthetics during caudal anesthesia in children...
October 11, 2016: Regional Anesthesia and Pain Medicine
Ma Paz Redondo-Del-Río, Ma Alicia Camina-Martín, Laura Moya-Gago, Sandra de-la-Cruz-Marcos, Vincenzo Malafarina, Beatriz de-Mateo-Silleras
OBJECTIVE: To compare body composition as assessed by conventional and vector bioelectrical impedance analysis according to the nutritional cataloging using body mass index (BMI) in a group of institutionalized elderly. METHODS: Cross-sectional study in 38 institutionalized elderly. Body composition was estimated by bioimpedance analysis. Differences in body composition were analyzed using t-test and ANOVA, or their corresponding nonparametric tests. Statistical significance was set at p<0...
October 10, 2016: Experimental Gerontology
Dorota Sikorska, Krzysztof Pawlaczyk, Anna Olewicz-Gawlik, Natasza Czepulis, Bartlomiej Posnik, Ewa Baum, Maria Wanic-Kossowska, Bengt Lindholm, Andrzej Oko
BACKGROUND: Peritoneal dialysis (PD) patients with preserved residual diuresis have a lower risk of death and complications. Here we analyzed associations between residual diuresis and presence of fluid overload and biomarkers of cardiac strain and nutrition in PD patients. METHODS: Among 44 PD patients placed into three subgroups, depending on volume of residual diuresis (group A ≤ 500; group B 600-1900; and group C ≥ 2000 mL/day), we examined: overhydration (OH) assessed by bioimpedance analysis (BIA; yielding OH index OHBIA) and by clinical criteria (edema and hypertension); nutritional status (by subjective global assessment, SGA); metabolic status (electrolytes, serum lipid profile, CRP, and albumin); biomarkers of fluid overload and cardiac strain (N-terminal probrain natriuretic peptide, NT-proBNP, and troponin T, TnT); and, echocardiography and chest X-ray...
October 12, 2016: International Urology and Nephrology
Wilson Nadruz, Dalane Kitzman, Beverly Gwen Windham, Anna Kucharska-Newton, Kenneth Butler, Priya Palta, Michael E Griswold, Lynne E Wagenknecht, Gerardo Heiss, Scott D Solomon, Hicham Skali, Amil M Shah
BACKGROUND: The contribution of cardiovascular dysfunction to frailty in older adults is uncertain. This study aimed to define the relationship between frailty and cardiovascular structure and function, and determine whether these associations are independent of coexisting abnormalities in other organ systems. METHODS: We studied 3,991 older adults (mean age 75.6±5.0 years; 59% female) from the Atherosclerosis Risk in Communities (ARIC) Study in whom the following six organ systems were uniformly assessed: cardiac (by echocardiography), vascular (by ankle-brachial-index and pulse-wave-velocity), pulmonary (by spirometry), renal (by estimated glomerular filtration rate), hematologic (by hemoglobin), and adipose (by body mass index and bioimpedance)...
October 12, 2016: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Takahiro Masuda, Takuya Murakami, Yusuke Igarashi, Kyochika Okabe, Takahisa Kobayashi, Shin-Ichi Takeda, Takako Saito, Chuji Sekiguchi, Yasuharu Miyazawa, Tetsu Akimoto, Osamu Saito, Shigeaki Muto, Daisuke Nagata
Objective Tolvaptan, an oral selective V2-receptor antagonist, is a water diuretic that ameliorates fluid retention with a lower risk of a worsening renal function than conventional loop diuretics. Although loop diuretics predominantly decrease extracellular water (ECW) compared with intracellular water (ICW), the effect of tolvaptan on fluid distribution remains unclear. We therefore examined how tolvaptan changes ICW and ECW in accordance with the renal function. Methods Six advanced chronic kidney disease patients (stage 4 or 5) with fluid retention were enrolled in this study...
2016: Internal Medicine
Magdalena Krajewska-Włodarczyk
The clinical picture of rheumatoid arthritis covers the condition of chronic inflammation connected to the increased concentration of inflammatory mediators, reduced physical activity, immobilization caused by pain, stiffness and joint destruction as well as accompanying hormonal and metabolic disorders. It all may lead to extra-articular complications, also to the loss of muscle mass with the weakness of muscle strength, adding to the disability and significantly lowering the patients' quality of life. Sarcopenia is an advanced form of muscle mass loss which constitutes an independent and vital threat for dexterity...
2016: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
H Sadhna, R Harris, J L Miles-Chan, S Yves, M Jean-Pierre, J Noorjehan, A G Dulloo
BACKGROUND & AIMS: Global estimates of overweight and obesity prevalence are based upon the World Health Organisation (WHO) body mass index (BMI) cut-off values of 25 and 30 kg/m(2), respectively. To validate these BMI cut-offs for adiposity in the island population of Mauritius, we assessed the relationship between BMI and measured body fat mass in this population according to gender and ethnicity. METHODS: In 175 young adult Mauritians (age 20-42 years) belonging to the two main ethnic groups-Indians (South Asian descent) and Creoles (African/Malagasy descent), body weight, height and waist circumference (WC) were measured, total body fat assessed by Deuterium oxide (D2O) dilution, and trunk (abdominal) fat by segmental bioimpedance analysis...
October 4, 2016: International Journal of Obesity: Journal of the International Association for the Study of Obesity
Anil Koklu, Ahmet C Sabuncu, Ali Beskok
Electrode polarization at the electrolyte/electrode interface is often undesirable for bio-sensing applications, where charge accumulated over an electrode at constant potential causes large potential drop at the interface and low measurement sensitivity. In this study, novel rough electrodes were developed for decreasing electrical impedance at the interface. The electrodes were fabricated using electrochemical deposition of gold and sintering of gold nanoparticles. The performances of the gold electrodes were compared with platinum black electrodes...
July 1, 2016: Electrochimica Acta
Bojan Gavrilovic, T Douglas Bradley, Daniel Vena, Owen D Lyons, Joseph M Gabriel, Milos R Popovic, Azadeh Yadollahi
OBJECTIVES: Obstructive sleep apnea (OSA) is highly prevalent in patients with fluid-retaining conditions. Using bioimpedance measurements, previous studies have shown that the greater the amount of fluid redistributed from the legs to the neck overnight, the greater the severity of OSA. Our objective was to investigate factors that predispose the development or worsening of OSA in response to experimental fluid overload. METHODS: Fifteen normotensive and non-obese adult men with and without OSA underwent polysomnography (PSG) during which normal saline was infused intravenously at a minimal rate to keep the vein open (control) or as a bolus of 22 ml/kg body weight (approximately 2 L) in a random order and crossed over after a week...
July 2016: Sleep Medicine
D Lo Presti, G Gagliardi, G M Tiralongo, I Pisani, D Farsetti, R L Scala, G P Novelli, B Vasapollo, A Andreoli, H Valensise
INTRODUCTION: Several studies have demonstrated the correlation between maternal obesity and pregnancy complications. Obese women seem to be at higher risk to develop late preeclampsia, which shows a more favorable perinatal outcome compared to the early form. The assessment of total vascular resistance (TVR) could play an additional role in the detection of these patients. Targets: To identify patients at higher risk of hypertensive complications through the assessment of pre-pregnancy maternal fat mass (FM) and TVR...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
A S Staelens, S Vonck, G Molenberghs, M Lng Malbrain, W Gyselaers
INTRODUCTION: Body fluid composition (BFC) changes during the course of pregnancy and evidence is growing that these changes are different in uncomplicated pregnancies compared to hypertensive pregnancies. METHODS: The aim of this study was to evaluate the changes in maternal BFC during the course of uncomplicated pregnancy (UP) using bioimpedance analysis, as a reference to measurements in hypertensive pregnancies. BFC was assessed using a multiple frequency bioelectrical impedance analyser...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
I Pisani, D Lo Presti, G M Tiralongo, G Gagliardi, D Farsetti, B Vasapollo, G P Novelli, A Andreoli, H Valensise
INTRODUCTION: During pregnancy, maternal body composition and haemodynamics undergo important changes that are of increasing interest for understanding the evolving maternal physiology. Targets: To assess and correlate changes in body composition and haemodynamic function of healthy normotensive pregnant women. To identify different populations based on TVR values, we enrolled 235 patients subjected to bioimpedance analysis and haemodynamic assessment using the USCOM system. RESULTS: We found an increase of BMI as result of an increase of all its components and a change in water distribution: ECW percentage increases while ICW decreases (see table)...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
G Gagliardi, G M Tiralongo, D Lo Presti, I Pisani, D Farsetti, B Vasapollo, G P Novelli, A Andreoli, H Valensise
INTRODUCTION: Abnormalities of cardiac output, TVR and water body distribution are connected with PE and foetal growth restriction (FGR). Targets: To identify patients at risk of PE in the first trimester through USCOM system, bioimpedance and combined screening (maternal history, biophysical and biochemical markers). We enrolled 150 healthy nulliparous women with normal BMI. RESULTS: The patients were divided into two groups: Group A (TVR <1200 dynes sec cm(-5)), Group B (TVR41200 dynes sec cm(-5))...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
K Tangvoraphonkchai, A Davenport
BACKGROUND/OBJECTIVES: Patients with chronic kidney disease treated by haemodialysis (HD) are at increased risk of sarcopenia. Bioelectrical impedance spectroscopy (BIS) can be used to determine body composition, and is one of the several potential screening tools for sarcopenia. The newer generation of portable hand-held devices can be readily used in dialysis centres. The results from BIS devices using a two-compartmental model of body composition can be affected by hydration status and so ideally measurements should be made when patients are not overhydrated...
September 28, 2016: European Journal of Clinical Nutrition
Janet Douglass, Patricia Graves, Susan Gordon
BACKGROUND: Measurements of tissue compressibility and extracellular fluid (ECF) are used to monitor progression of lymphedema, a chronic swelling of the subcutaneous tissue. Later stages of lymphedema are characterized by fibrotic induration in the subcutis and hyperkeratosis of the skin. Several devices are available to measure these changes, but previous reliability and validity studies have been conducted primarily on adult women with unilateral arm lymphedema using contralateral limbs as controls...
September 27, 2016: Lymphatic Research and Biology
Adam J Kuchnia, Levi M Teigen, Abigail J Cole, Urvashi Mulasi, M Cristina Gonzalez, Steven B Heymsfield, David M Vock, Carrie P Earthman
BACKGROUND: Raw bioimpedance parameters (eg, 50-kHz phase angle [PA] and 200-kHz/5-kHz impedance ratio [IR]) have been investigated as predictors of nutrition status and/or clinical outcomes. However, their validity as prognostic measures depends on the availability of appropriate reference data. Using a large and ethnically diverse data set, we aimed to determine if ethnicity influences these measures and provide expanded bioimpedance reference data for the U.S. POPULATION: HASH(0x47dead8) METHODS: The National Health and Nutrition Examination Survey (NHANES) is an ongoing compilation of studies conducted by the U...
September 26, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Brett S Nickerson, Michael R Esco, Phillip A Bishop, Randall Schumacker, Mark Richardson, Michael V Fedewa, Jonathan E Wingo, Bailey A Welborn
The purpose of this study was to compare body fat percentage (BF%) and fat-free mass (FFM) values from bioelectrical impedance analysis (BIA) equations to values determined from a four-compartment (4C) model. Eighty-two adults (42 men and 40 women) volunteered to participate (age = 23 ± 5 years). BF% and FFM were estimated from previously developed BIA equations by Chumlea et al. (BIACH), Deurenberg et al. (BIADE), Kyle et al. (BIAKYLE), and Sun et al. (BIASUN). 4C model body composition was derived from underwater weighing for body density, dual energy X-ray absorptiometry for bone mineral content, and bioimpedance spectroscopy for total body water...
September 20, 2016: Journal of Strength and Conditioning Research
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