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Liu S, Feng Y, Zhang Q, Lu J, Li N, Liu Y, Jiang C. Comparison of the Watson formula and bioimpedance spectroscopy for measuring body volume and calculating kt/V in patients with peritoneal dialysis. Ren Fail 2024; 46:2313360. [PMID: 38345032 PMCID: PMC10863529 DOI: 10.1080/0886022x.2024.2313360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/28/2024] [Indexed: 02/15/2024] Open
Abstract
CONCLUSION There were significant differences between Vwat and Vbis and between Kt/Vwat and Kt/Vbis. Kt/Vwat may underestimate small-solute dialysis adequacy in most cases. Kt/Vbis instead of Kt/Vwat could be accounted for in creating individualized dialysis prescriptions if the patient has no obvious clinical symptoms.
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Affiliation(s)
- Sixiu Liu
- Department of Nephrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China
| | - Yuan Feng
- Department of Nephrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China
| | - Qingyan Zhang
- Department of Nephrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China
| | - Jian Lu
- Department of Nephrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China
| | - Nan Li
- Department of Nephrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China
| | - Ying Liu
- Department of Nephrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China
| | - Chunming Jiang
- Department of Nephrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China
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Nikitiuk BE, Rydzewska-Rosołowska A, Kakareko K, Głowińska I, Hryszko T. On Whether Ca-125 Is the Answer for Diagnosing Overhydration, Particularly in End-Stage Kidney Disease Patients-A Systematic Review. Int J Mol Sci 2024; 25:2192. [PMID: 38396869 PMCID: PMC10889175 DOI: 10.3390/ijms25042192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
Overhydration (OH) is a prevalent medical problem that occurs in patients with kidney failure, but a specific marker has still not been found. Patients requiring kidney replacement therapy suffer from a water imbalance, which is correlated with mortality rates in this population. Currently, clinicians employ techniques such as bioimpedance spectroscopy (BIS) and ultrasound (USG) markers of overhydration or markers of heart and kidney function, namely NT-pro-BNP, GFR, or creatinine levels. New serum markers, including but not limited to Ca-125, galectin-3 (Gal-3), adrenomedullin (AMD), and urocortin-2 (UCN-2), are presently under research and have displayed promising results. Ca-125, which is a protein mainly used in ovarian cancer diagnoses, holds great potential to become an OH marker. It is currently being investigated by cardiologists as it corresponds to the volume status in heart failure (HF) and ventricular hypertrophy, which are also associated with OH. The need to ascertain a more precise marker of overhydration is urgent mainly because physical examinations are exceptionally inaccurate. The signs and symptoms of overhydration, such as edema or a gradual increase in body mass, are not always present, notably in patients with chronic kidney disease. Metabolic disruptions and cachexia can give a false picture of the hydration status. This review paper summarizes the existing knowledge on the assessment of a patient's hydration status, focusing specifically on kidney diseases and the role of Ca-125.
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Affiliation(s)
| | - Alicja Rydzewska-Rosołowska
- 2nd Department of Nephrology, Hypertension, and Internal Medicine with Dialysis Unit, Medical University of Bialystok, 15-276 Bialystok, Poland; (B.E.N.); (K.K.); (I.G.); (T.H.)
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3
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Zhang W, Cui X, Li R, Ji W, Shi H, Cui J. Association between ICW/TBW ratio and cancer prognosis: Subanalysis of a population-based retrospective multicenter study. Clin Nutr 2024; 43:322-331. [PMID: 38142477 DOI: 10.1016/j.clnu.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/08/2023] [Accepted: 12/05/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND & AIMS Disease burden is known to alter cellular integrity and water balance. Therefore, the intracellular water/total body water (ICW/TBW) ratio is used as an adjunctive indicator to predict disease severity and prognosis. The ICW/TBW ratio of patients with cancer, who typically present with low muscle mass, poor nutritional status, and high inflammatory response, reportedly differs from that of the healthy population. Herein, we aimed to evaluate the effect of the ICW/TBW ratio on the prognosis of different subgroups of patients with cancer. METHODS This multicenter cohort study included 2787 patients with malignancies between June 2014 and December 2018. The association between covariates and overall survival (OS) was assessed using restricted cubic spline models. The multivariate Cox regression model included variables demonstrating a statistical significance in the univariate Cox regression analysis (P < 0.05) without multicollinearity. The generated nomogram used the C-index and calibration curves to validate the predictive accuracy of the scoring system. RESULTS The optimal cut-off value for the ICW/TBW ratio was 0.61. The ICW/TBW ratio was an independent prognostic factor (hazard ratio [HR]: 0.621; 95 % confidence interval [CI]: 0.537-0.719, P < 0.001). Moreover, the ICW/TBW ratio had a greater impact on the prognosis of patients receiving chemoradiotherapy than on those receiving chemotherapy alone (chemoradiotherapy: HR = 0.495, P = 0.005 vs. chemotherapy: HR = 0.646, P < 0.001). Multivariate Cox regression analysis showed that sex, age, tumor stage, body mass index, neutrophil-to-lymphocyte ratio (NLR), and ICW/TBW ratio were associated with OS. Subsequently, a nomogram was developed incorporating these variables and yielded a C-index of 0.743. CONCLUSIONS The ICW/TBW ratio was associated with muscle mass, nutritional status, and inflammation. A low ICW/TBW ratio is an independent risk factor for poor prognosis in patients with cancer, especially when they are female, have advanced cancer stage, have sarcopenia, and are receiving radiotherapy.
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Affiliation(s)
- Wenxin Zhang
- Zhongnan Hospital of Wuhan University, Wuhan, China.
| | - Xiao Cui
- Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Rumeng Li
- Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Wei Ji
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Hanping Shi
- Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
| | - Jiuwei Cui
- Cancer Center, The First Hospital of Jilin University, Changchun, China.
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4
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Homer KA, Cross MR, Helms ER. Peak Week Carbohydrate Manipulation Practices in Physique Athletes: A Narrative Review. SPORTS MEDICINE - OPEN 2024; 10:8. [PMID: 38218750 PMCID: PMC10787737 DOI: 10.1186/s40798-024-00674-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 01/02/2024] [Indexed: 01/15/2024]
Abstract
BACKGROUND Physique athletes are ranked by a panel of judges against the judging criteria of the corresponding division. To enhance on-stage presentation and performance, competitors in certain categories (i.e. bodybuilding and classic physique) achieve extreme muscle size and definition aided by implementing acute "peaking protocols" in the days before competition. Such practices can involve manipulating nutrition and training variables to increase intramuscular glycogen and water while minimising the thickness of the subcutaneous layer. Carbohydrate manipulation is a prevalent strategy utilised to plausibly induce muscle glycogen supercompensation and subsequently increase muscle size. The relationship between carbohydrate intake and muscle glycogen saturation was first examined in endurance event performance and similar strategies have been adopted by physique athletes despite the distinct physiological dissimilarities and aims between the sports. OBJECTIVES The aim of this narrative review is to (1) critically examine and appraise the existing scientific literature relating to carbohydrate manipulation practices in physique athletes prior to competition; (2) identify research gaps and provide direction for future studies; and (3) provide broad practical applications based on the findings and physiological reasoning for coaches and competitors. FINDINGS The findings of this review indicate that carbohydrate manipulation practices are prevalent amongst physique athletes despite a paucity of experimental evidence demonstrating the efficacy of such strategies on physique performance. Competitors have also been observed to manipulate water and electrolytes in conjunction with carbohydrate predicated on speculative physiological mechanisms which may be detrimental for performance. CONCLUSIONS Further experimental evidence which closely replicates the nutritional and training practices of physique athletes during peak week is required to make conclusions on the efficacy of carbohydrate manipulation strategies. Quasi-experimental designs may be a feasible alternative to randomised controlled trials to examine such strategies due to the difficulty in recruiting the population of interest. Finally, we recommend that coaches and competitors manipulate as few variables as possible, and experiment with different magnitudes of carbohydrate loads in advance of competition if implementing a peaking strategy.
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Affiliation(s)
- Kai A Homer
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, 17 Antares Place, Rosedale, Auckland, 0632, New Zealand.
| | - Matt R Cross
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, 17 Antares Place, Rosedale, Auckland, 0632, New Zealand
| | - Eric R Helms
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, 17 Antares Place, Rosedale, Auckland, 0632, New Zealand
- Department of Exercise Science and Health Promotion, Muscle Physiology Laboratory, Florida Atlantic University, Boca Raton, FL, USA
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5
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Silva AM, Campa F, Stagi S, Gobbo LA, Buffa R, Toselli S, Silva DAS, Gonçalves EM, Langer RD, Guerra-Júnior G, Machado DRL, Kondo E, Sagayama H, Omi N, Yamada Y, Yoshida T, Fukuda W, Gonzalez MC, Orlandi SP, Koury JC, Moro T, Paoli A, Kruger S, Schutte AE, Andreolli A, Earthman CP, Fuchs-Tarlovsky V, Irurtia A, Castizo-Olier J, Mascherini G, Petri C, Busert LK, Cortina-Borja M, Bailey J, Tausanovitch Z, Lelijveld N, Ghazzawi HA, Amawi AT, Tinsley G, Kangas ST, Salpéteur C, Vázquez-Vázquez A, Fewtrell M, Ceolin C, Sergi G, Ward LC, Heitmann BL, da Costa RF, Vicente-Rodriguez G, Cremasco MM, Moroni A, Shepherd J, Moon J, Knaan T, Müller MJ, Braun W, García-Almeida JM, Palmeira AL, Santos I, Larsen SC, Zhang X, Speakman JR, Plank LD, Swinburn BA, Ssensamba JT, Shiose K, Cyrino ES, Bosy-Westphal A, Heymsfield SB, Lukaski H, Sardinha LB, Wells JC, Marini E. The bioelectrical impedance analysis (BIA) international database: aims, scope, and call for data. Eur J Clin Nutr 2023; 77:1143-1150. [PMID: 37532867 DOI: 10.1038/s41430-023-01310-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Bioelectrical impedance analysis (BIA) is a technique widely used for estimating body composition and health-related parameters. The technology is relatively simple, quick, and non-invasive, and is currently used globally in diverse settings, including private clinicians' offices, sports and health clubs, and hospitals, and across a spectrum of age, body weight, and disease states. BIA parameters can be used to estimate body composition (fat, fat-free mass, total-body water and its compartments). Moreover, raw measurements including resistance, reactance, phase angle, and impedance vector length can also be used to track health-related markers, including hydration and malnutrition, and disease-prognostic, athletic and general health status. Body composition shows profound variability in association with age, sex, race and ethnicity, geographic ancestry, lifestyle, and health status. To advance understanding of this variability, we propose to develop a large and diverse multi-country dataset of BIA raw measures and derived body components. The aim of this paper is to describe the 'BIA International Database' project and encourage researchers to join the consortium. METHODS The Exercise and Health Laboratory of the Faculty of Human Kinetics, University of Lisbon has agreed to host the database using an online portal. At present, the database contains 277,922 measures from individuals ranging from 11 months to 102 years, along with additional data on these participants. CONCLUSION The BIA International Database represents a key resource for research on body composition.
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Affiliation(s)
- Analiza M Silva
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002, Lisbon, Portugal.
| | - Francesco Campa
- Department of Biomedical Science, University of Padova, 35100, Padova, Italy
| | - Silvia Stagi
- Department of Life and Environmental Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, 09042, Cagliari, Italy
| | - Luís A Gobbo
- Skeletal Muscle Assessment Laboratory, Physical Education Department, School of Technology and Science, São Paulo State University, Presidente Prudente, 19060-900, Brazil
| | - Roberto Buffa
- Department of Life and Environmental Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, 09042, Cagliari, Italy
| | - Stefania Toselli
- Department for Life Quality Studies, University of Bologna, 47921, Rimini, Italy
| | - Diego Augusto Santos Silva
- Research Center of Kinanthropometry and Human Performance, Sports Center, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Ezequiel M Gonçalves
- Growth and Development Laboratory, Center for Investigation in Pediatrics (CIPED), School of Medical Sciences, University of Campinas (UNICAMP), Campinas, 13083-887, Brazil
| | - Raquel D Langer
- Growth and Development Laboratory, Center for Investigation in Pediatrics (CIPED), School of Medical Sciences, University of Campinas (UNICAMP), Campinas, 13083-887, Brazil
| | - Gil Guerra-Júnior
- Growth and Development Laboratory, Center for Investigation in Pediatrics (CIPED), School of Medical Sciences, University of Campinas (UNICAMP), Campinas, 13083-887, Brazil
| | - Dalmo R L Machado
- Laboratory of Kinanthropometry and Human Performance, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, 05508-030, São Paulo, Brazil
| | - Emi Kondo
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, 305-8574, Japan
| | - Hiroyuki Sagayama
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, 305-8574, Japan
| | - Naomi Omi
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, 305-8574, Japan
| | - Yosuke Yamada
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, 566-0002, Japan
| | - Tsukasa Yoshida
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, 566-0002, Japan
| | - Wataru Fukuda
- Yokohama Sports Medical Center, Yokohama Sport Association, Kanagawa, 222-0036, Japan
| | - Maria Cristina Gonzalez
- Postgraduate Program in Nutrition and Food, Federal University of Pelotas, 96010-610 Pelotas, Brazil
| | - Silvana P Orlandi
- Nutrition Department, Federal University of Pelotas, 96010-610, Pelotas, Brazil
| | - Josely C Koury
- Nutrition Institute, State University of Rio de Janeiro, 20550-013, Rio de Janeiro, Brazil
| | - Tatiana Moro
- Department of Biomedical Science, University of Padova, 35100, Padova, Italy
| | - Antonio Paoli
- Department of Biomedical Science, University of Padova, 35100, Padova, Italy
| | - Salome Kruger
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, 2520, South Africa
| | - Aletta E Schutte
- School of Population Health, University of New South Wales, The George Institute for Global Health, Sydney, NSW, Australia
| | | | | | | | - Alfredo Irurtia
- National Institute of Physical Education of Catalonia (INEFC), University of Barcelona (UB), Barcelona, Spain
| | - Jorge Castizo-Olier
- School of Health Sciences, TecnoCampus, Pompeu Fabra University, Barcelona, Spain
| | - Gabriele Mascherini
- Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy
| | - Cristian Petri
- Department of Sports and Computer Science, Section of Physical Education and Sports, Universidad Pablo de Olavide, Seville, Spain
| | - Laura K Busert
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Mario Cortina-Borja
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | | | | | | | - Hadeel Ali Ghazzawi
- Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman, Jordan
| | - Adam Tawfiq Amawi
- Department of Physical and Health Education, Faculty of Educational Sciences, Al-Ahliyya Amman University, Al-Salt, Jordan
| | - Grant Tinsley
- Energy Balance & Body Composition Laboratory, Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX, 79409, USA
| | - Suvi T Kangas
- International Rescue Committee, New York, NY, 10168, USA
| | - Cécile Salpéteur
- Department of Expertise and Advocacy, Action contre la Faim, 93358, Montreuil, France
| | - Adriana Vázquez-Vázquez
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Mary Fewtrell
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Chiara Ceolin
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, 35128, Italy
| | - Giuseppe Sergi
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, 35128, Italy
| | - Leigh C Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Berit L Heitmann
- Research Unit for Dietary Studies, The Parker Institute, Frederiksberg and Bispebjerg Hospital, Copenhagen, Denmark
- Section for general Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Roberto Fernandes da Costa
- Department of Physical Education, Research Group in Physical Activity and Health, Federal University of Rio Grande do Norte, Natal, Brazil
| | - German Vicente-Rodriguez
- Faculty of Health and Sport Science FCSD, Department of Physiatry and Nursing, University of Zaragoza, 50009, Zaragoza, Spain
| | - Margherita Micheletti Cremasco
- Laboratory of Anthropology, Anthropometry and Ergonomics, Department of Life Sciences and Systems Biology, University of Torino, 10123, Torino, Italy
| | - Alessia Moroni
- Laboratory of Anthropology, Anthropometry and Ergonomics, Department of Life Sciences and Systems Biology, University of Torino, 10123, Torino, Italy
| | - John Shepherd
- University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Jordan Moon
- United States Sports Academy, Daphne, AL, 36526, USA
| | - Tzachi Knaan
- Weight Management, Metabolism & Sports Nutrition Clinic, Metabolic Lab, Tel-Aviv, Tel Aviv-Yafo, Israel
| | - Manfred J Müller
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Christian-Albrechts University, 24105, Kiel, Germany
| | - Wiebke Braun
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Christian-Albrechts University, 24105, Kiel, Germany
| | - José M García-Almeida
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital, Malaga University, 29010, Malaga, Spain
| | | | - Inês Santos
- Laboratório de Nutrição, Faculdade de Medicina, Centro Académico de Medicina de Lisboa, Universidade de Lisboa, Lisboa, Portugal
| | - Sofus C Larsen
- Research Unit for Dietary Studies at the Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, Frederiksberg, Denmark
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Xueying Zhang
- Shenzhen Key Laboratory of Metabolic Health, Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - John R Speakman
- Shenzhen Key Laboratory of Metabolic Health, Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- School of Biological Sciences, University of Aberdeen, Aberdeen, UK
| | - Lindsay D Plank
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Boyd A Swinburn
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Jude Thaddeus Ssensamba
- Center for Innovations in Health Africa (CIHA Uganda), Kampala, Uganda
- Makerere University Walter Reed Project, Kampala, Uganda
| | - Keisuke Shiose
- Faculty of Education, University of Miyazaki, Miyazaki, Japan
| | - Edilson S Cyrino
- Metabolism, Nutrition, and Exercise Laboratory. Physical Education and Sport Center, State University of Londrina, Rod. Celso Garcia Cid, Km 380, 86057-970, Londrina-PR, Brazil
| | - Anja Bosy-Westphal
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Christian-Albrechts University, 24105, Kiel, Germany
| | | | - Henry Lukaski
- Department of Kinesiology and Public Health Education, Hyslop Sports Center, University of North Dakota Grand Forks, Grand Forks, ND, 58202, USA
| | - Luís B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002, Lisbon, Portugal
| | - Jonathan C Wells
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Elisabetta Marini
- Department of Life and Environmental Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, 09042, Cagliari, Italy
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Athavale A, Miles N, Pais R, Snelling P, Chadban SJ. Transdermal Magnesium for the Treatment of Peripheral Neuropathy in Chronic Kidney Disease: A Single-Arm, Open-Label Pilot Study. J Palliat Med 2023; 26:1654-1661. [PMID: 37486715 DOI: 10.1089/jpm.2023.0229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
Introduction: Peripheral neuropathy is common in chronic kidney disease (CKD) and may be multifactorial in origin, resulting from uremia, hyperkalemia, and diabetes. Previous studies have suggested that magnesium plays a crucial role in chronic pain. Studies evaluating magnesium in neuropathy have demonstrated mixed results. Aims: To provide preliminary data on the effectiveness of transdermal magnesium in treating peripheral neuropathy related to CKD. Methods: Twenty participants with advanced CKD were enrolled from a major teaching hospital clinic in Sydney, Australia. Each participant was provided with a spray bottle containing magnesium chloride and instructed to apply five sprays to each limb affected by neuropathy daily for 12 weeks. Participants completed the Neuropathy Total Symptom Score-6 (NTSS-6) every 4 weeks during follow-up. Serum magnesium concentrations were measured at 4-week intervals. Results: Twenty participants were recruited, of which 14 completed the 12-week follow-up period. Mean age was 78.90 years, 80.00% were female and mean estimated glomerular filtration rate was 9.78 mL/min/1.73 m2. With intention to treat analysis (mean [95% confidence interval]), NTSS-6 was significantly reduced at weeks 8 (4.04 [2.43-5.65]) and 12 (4.26 [2.47-6.05]), compared with baseline (6.92 [5.29-8.55]), p < 0.05. Serum magnesium concentration did not change significantly during the study. Conclusion: This pilot study suggests that transdermal magnesium may be beneficial in reducing frequency and severity of peripheral neuropathic symptoms in patients with advanced CKD. Trial Registration: australianclinicaltrials.gov.au. Identifier: ACTRN12621000841875. Date first registered January 7, 2021.
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Affiliation(s)
- Akshay Athavale
- Department of Renal Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Natividad Miles
- Department of Renal Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Riona Pais
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Department of Palliative Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Paul Snelling
- Department of Renal Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Steven J Chadban
- Department of Renal Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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Elkalawy H, Sekhar P, Abosena W. Early detection and assessment of intensive care unit-acquired weakness: a comprehensive review. Acute Crit Care 2023; 38:409-424. [PMID: 38052508 DOI: 10.4266/acc.2023.00703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 10/17/2023] [Indexed: 12/07/2023] Open
Abstract
Intensive care unit-acquired weakness (ICU-AW) is a serious complication in critically ill patients. Therefore, timely and accurate diagnosis and monitoring of ICU-AW are crucial for effectively preventing its associated morbidity and mortality. This article provides a comprehensive review of ICU-AW, focusing on the different methods used for its diagnosis and monitoring. Additionally, it highlights the role of bedside ultrasound in muscle assessment and early detection of ICU-AW. Furthermore, the article explores potential strategies for preventing ICU-AW. Healthcare providers who manage critically ill patients utilize diagnostic approaches such as physical exams, imaging, and assessment tools to identify ICU-AW. However, each method has its own limitations. The diagnosis of ICU-AW needs improvement due to the lack of a consensus on the appropriate approach for its detection. Nevertheless, bedside ultrasound has proven to be the most reliable and cost-effective tool for muscle assessment in the ICU. Combining the Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation (APACHE) II score assessment, and ultrasound can be a convenient approach for the early detection of ICU-AW. This approach can facilitate timely intervention and prevent catastrophic consequences. However, further studies are needed to strengthen the evidence.
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Affiliation(s)
- Hanan Elkalawy
- Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, Boston, MA, USA
| | - Pavan Sekhar
- Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, Boston, MA, USA
| | - Wael Abosena
- Department of Surgery, Faculty of Medicine, Tanta University, Gharbeya, Egypt
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8
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Reichmann MTF, Duarte A, Ivano F, Campos ACL. Factors Involved in the Evolution of the Basal Metabolic Rate over 30 Months After Roux-en-Y Gastric Bypass. Obes Surg 2023; 33:3494-3501. [PMID: 37792252 DOI: 10.1007/s11695-023-06853-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/15/2023] [Accepted: 09/24/2023] [Indexed: 10/05/2023]
Abstract
INTRODUCTION After Roux-en-Y gastric bypass (RYGB), the basal metabolic rate (BMR) falls. However, it is important to know how BMR per kilogram of body weight (BMR/kg) varies in the postoperative period. The present study evaluated the changes in the BMR/kg and its correlates over 30 months after RYGB. METHODS Eighty adult patients of both genders who underwent RYGB agreed to participate in the study. The following evaluations were performed before surgery (n=48) and 6 (n=27), 12 (n=28), 24 (n=40), and 30 months (n=29) after surgery: anthropometry, body composition (bioelectrical impedance), metabolic analysis (indirect calorimetry), and diet (food recall). Statistical analysis was performed (p = 0.05). RESULTS Although BMR decreased after surgery, BMR/kg increased significantly as compared to baseline from 12 months onward, peaking at 24 months and not significantly dipping at 30 months, suggesting stabilization of BMR/kg 2 years after surgery (pre, 10.68 ± 2.33 kcal/kg; 12 months, 12.46 ± 2.85 kcal/kg; 24 months, 18.78 ± 4.81 kcal/kg; 30 months, 18.12 ± 3.69 kcal/kg; p <0.001). Regarding the variables that influenced the BMR/kg, at 12 months, they were %LBM and intake of calcium-source foods (34%); at 24 months, it was protein intake (16%); and at 30 months, it was the intake of calcium-source foods (26.7%). CONCLUSION RYGB is associated with a significant increase in BMR when it is adjusted to body weight from 12 to 24 months postoperatively. Among the factors involved in the increase in BMR/kg are body composition and intake of protein-rich foods.
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Affiliation(s)
- Michelle T F Reichmann
- Universidade Federal do Paraná (UFPR), Rua General Carneiro, 181, Centro, Curitiba, PR, Brazil.
- , Curitiba, Brazil.
| | - Alexia Duarte
- Universidade Federal do Paraná (UFPR), Rua General Carneiro, 181, Centro, Curitiba, PR, Brazil
| | - Flavio Ivano
- Pontifícia Universidade Católica do Paraná (PUCPR), Rua Imaculada Conceição, Curitiba, PR, 1155, Brazil
| | - Antonio Carlos L Campos
- Universidade Federal do Paraná (UFPR), Rua General Carneiro, 181, Centro, Curitiba, PR, Brazil
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9
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Cai B, Luo L, Zhu C, Meng L, Shen Q, Fu Y, Wang M, Chen S. Influence of body composition assessment with bioelectrical impedance vector analysis in cancer patients undergoing surgery. Front Oncol 2023; 13:1132972. [PMID: 37736552 PMCID: PMC10509551 DOI: 10.3389/fonc.2023.1132972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 08/15/2023] [Indexed: 09/23/2023] Open
Abstract
Background Malnutrition is common in patients undergoing surgery for cancers and is a risk factor for postoperative outcomes. Body composition provides information for precise nutrition intervention in perioperative period for improving patients' postoperative outcomes. Objection The aim was to determine changes in parameters of body composition and nutritional status of cancer patients during perioperative period. Methods A total of 92 patients diagnosed with cancer were divided into gastrointestinal and non-gastrointestinal cancer group according to different cancer types. The patients body composition assessed by bioelectrical impedance vector analysis (BIVA) on the day before surgery, postoperative day 1 and 1 day before discharge. The changes between two groups were compared and the correlation between body composition and preoperative serum nutritional indexes was analyzed. Results The nutritional status of all patients become worse after surgery, and phase angle (PA) continued to decrease in the perioperative period. Fat-free mass (FFM), fat-free mass index (FFMI), skeletal muscle mass (SMM), extracellular water (ECW), total body water (TBW), hydration, and body cell mass (BCM) rise slightly and then fall in the postoperative period in patients with gastrointestinal cancer, and had a sustained increase in non-gastrointestinal patients, respectively (P<0.05). Postoperative body composition changes in patients with gastrointestinal cancer are related to preoperative albumin, pre-albumin, hemoglobin, and C-reactive protein (P<0.05), whereas postoperative body composition changes in patients with non-gastrointestinal cancer are related to age (P<0.05). Conclusions Significant changes in body composition both in patients with gastrointestinal cancer and non-gastrointestinal cancer during perioperative period are observed. Changes in body composition for the cancer patients who undergoing surgery are related to age and preoperative serum nutrition index.
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Affiliation(s)
- Bin Cai
- Department of Quality Management, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Department of Clinical Nutrition, Shaoxing People’s Hospital, Shaoxing, Zhejiang, China
| | - Lan Luo
- Department of Clinical Nutrition, Shaoxing People’s Hospital, Shaoxing, Zhejiang, China
| | - Chenping Zhu
- Department of Clinical Nutrition, Shaoxing People’s Hospital, Shaoxing, Zhejiang, China
| | - Liping Meng
- Department of Clinical Nutrition, Shaoxing People’s Hospital, Shaoxing, Zhejiang, China
| | - Qing Shen
- Department of Clinical Nutrition, Shaoxing People’s Hospital, Shaoxing, Zhejiang, China
| | - Yafei Fu
- Department of Clinical Nutrition, Shaoxing People’s Hospital, Shaoxing, Zhejiang, China
| | - Mingjie Wang
- Department of Clinical Nutrition, Shaoxing People’s Hospital, Shaoxing, Zhejiang, China
- School of Medicine, Shaoxing University, Shaoxing, Zhejiang, China
| | - Sue Chen
- Department of Clinical Nutrition, Shaoxing People’s Hospital, Shaoxing, Zhejiang, China
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Kimura J, Sui K, Tabuchi M, Sakamoto S, Murokawa T, Iwata J, Morita S, Iiyama T, Okabayashi T. Preoperative percent body fat in bioelectrical impedance analysis predicts pancreatic fistula after pancreaticoduodenectomy. Langenbecks Arch Surg 2023; 408:248. [PMID: 37380749 DOI: 10.1007/s00423-023-02998-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 06/21/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND It is unclear which body composition affects postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy. In the present study, we evaluated the relationship between nutritional factors, body composition, and POPF. METHODS This was a prospective observational cohort study. Patients who underwent pancreaticoduodenectomy between March 2018 and July 2021 were included in this study. Preoperative body composition was measured using a bioelectrical impedance analyzer. In addition, the predictive factors for POPF were analyzed using logistic regression model. RESULTS The study included 143 patients. Among these patients, 31 had POPF (POPF group) and 112 did not (non-POPF group) after pancreaticoduodenectomy. For body composition, the percent body fat was significantly higher in the POPF group (26.90 vs 23.48, P = 0.022). Multivariate analysis revealed that alcohol consumption (odds ratio 2.95, P = 0.03), pancreatic duct < 3 mm (odds ratio 3.89, P < 0.01), and percent body fat (odds ratio 1.08, P = 0.01) were significantly independent predictive factors for POPF. When the patients were divided into three groups based on their percent body fat (< 25, 25-35, and ≥ 35), POPF occurred more frequently in the group with ≥ 35 percent body fat (47.1%) than in the < 25 group (15.5%) (P = 0.008). CONCLUSION Predictive factors for POPF related to nutritional status, such as percent body fat, should be considered before proceeding to pancreaticoduodenectomy (ClinicalTrials.gov trial registration no. NCT5257434).
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Affiliation(s)
- Jiro Kimura
- Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125-1, Ike, Kochi City, Kochi, 781-8555, Japan
| | - Kenta Sui
- Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125-1, Ike, Kochi City, Kochi, 781-8555, Japan
| | - Motoyasu Tabuchi
- Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125-1, Ike, Kochi City, Kochi, 781-8555, Japan
| | - Shinya Sakamoto
- Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125-1, Ike, Kochi City, Kochi, 781-8555, Japan
| | - Takahiro Murokawa
- Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125-1, Ike, Kochi City, Kochi, 781-8555, Japan
| | - Jun Iwata
- Department of Diagnostic Pathology, Kochi Health Sciences Center, Kochi City, Kochi, Japan
| | - Sojiro Morita
- Department of Radiology, Kochi Health Sciences Center, Kochi City, Kochi, Japan
| | - Tastuo Iiyama
- Department of Biostatistics, National Center for Global Health and Medicine, Shinjuku City, Japan
| | - Takehiro Okabayashi
- Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125-1, Ike, Kochi City, Kochi, 781-8555, Japan.
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De Benedetto F, Marinari S, De Blasio F. Phase angle in assessment and monitoring treatment of individuals with respiratory disease. Rev Endocr Metab Disord 2023; 24:491-502. [PMID: 36694055 DOI: 10.1007/s11154-023-09786-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/05/2023] [Indexed: 01/26/2023]
Abstract
Phase angle (PhA) represents a raw variable measured with bioelectrical impedance analysis (BIA) that is used to assess malnutrition in many diseases, including respiratory diseases, mainly chronic obstructive pulmonary disease (COPD). COPD patients with reduced PhA are older, more hypoxic and hypercapnic; patients with more severe COPD have reduced cell mass, evident skeletal muscle depletion, and worsening gas exchange. Malnourished patients with stable COPD in long-term oxygen therapy (LTOT) have more intense dyspnea at rest, greater weight loss over the past 12 months, and more exacerbations per year. Multiple regression analysis highlighted the significance of PhA° in the estimation of muscle strength: hand grip strength (HGS) and in that of respiratory muscles: maximal inspiratory pressure / max. expiratory pressure ratio (MIP/MEP). Furthermore, the relationship between PhA° and all-cause mortality in COPD patients was confirmed with the Cox regression model, Kaplan-Meier test, and log-rank tests. The role of malnutrition in idiopathic pulmonary fibrosis (IPF) is confirmed by the PhA° measurements which, regardless of body weight, is associated with the reduction in muscle mass of these patients, reduces their strength and exercise capacity, and greatly influences the prognosis. In conclusion PhA is a novel biomarker of morbidity and mortality in patients with severe respiratory diseases.
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Affiliation(s)
- Fernando De Benedetto
- Scientific Director FISAR Foundation (Fondazione Salute Ambiente e Respiro), Chieti, Italy.
| | | | - Francesco De Blasio
- Respiratory Medicine and Pulmonary Rehabilitation Unit - Clinic Center Private Hospital, Naples, Italy
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Zhou C, Zhan L, He P, Yuan J, Zha Y. A Higher Whole-Body Extracellular to Intracellular Water Ratio Is Associated with Increased Odds of Cognitive Impairment in Hemodialysis Patients. J Alzheimers Dis 2023; 95:171-179. [PMID: 37522207 DOI: 10.3233/jad-230196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
BACKGROUND Cognitive impairment (CI) is highly prevalent in patients undergoing hemodialysis. Whether fluid overload with malnutrition as assessed by the ratio of extracellular water to intracellular water (ECW/ICW) is associated with CI in patients on maintenance hemodialysis (MHD) has yet to be studied. OBJECTIVE This study aimed to investigate the association between ECW/ICW and CI in patients with MHD. METHODS We conducted a multicenter, cross-sectional study that enrolled 3,025 adult patients with MHD. Cognitive function was assessed through the Mini-Mental State Examination. The ECW/ICW was derived from a portable body composition monitor and analyzed by quartiles. RESULTS 23.04% of participants had CI in our study. The prevalence of CI tended to increase as the quartiles of the ECW/ICW ratio increased. Unadjusted analysis showed that participants in quartile 4 were 3.02 times more likely to have a CI compared to those in quartile 1. After adjusting for age, sex, education, smoking status, body mass index, dialysis vintage, history of hypertension, and history of stroke, the adjusted OR (95% CI) for the highest quartile of ECW/ICW ratio was 1.36 (1.01, 1.83) for CI compared with the lowest quartile. Interestingly, the association between ECW/ICW ratio and CI persisted across all subgroups stratified by age, gender, history of diabetes, and stroke. (p for interaction > 0.05 for all). CONCLUSION An increased ECW/ICW ratio is associated with higher odds of cognitive impairment in patients undergoing hemodialysis.
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Affiliation(s)
- Chaomin Zhou
- Department of Nephrology, NHC Key Laboratory of Pulmonary Immune-related Diseases, Renal Division, Guizhou Provincial People's Hospital, Guiyang, China
- Medical College, Gui Zhou University, Guiyang, China
| | - Lin Zhan
- Research Laboratory Center, Guizhou Provincial People's Hospital, Guiyang, China
| | - Pinghong He
- Department of Nephrology, NHC Key Laboratory of Pulmonary Immune-related Diseases, Renal Division, Guizhou Provincial People's Hospital, Guiyang, China
| | - Jing Yuan
- Department of Nephrology, NHC Key Laboratory of Pulmonary Immune-related Diseases, Renal Division, Guizhou Provincial People's Hospital, Guiyang, China
| | - Yan Zha
- Department of Nephrology, NHC Key Laboratory of Pulmonary Immune-related Diseases, Renal Division, Guizhou Provincial People's Hospital, Guiyang, China
- Medical College, Gui Zhou University, Guiyang, China
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Cheng L, Chang L, Tian R, Zhou J, Luo F, Zhang H. The predictive value of bioimpedance-derived fluid parameters for cardiovascular events in patients undergoing hemodialysis. Ren Fail 2022; 44:1192-1200. [PMID: 35856161 PMCID: PMC9318232 DOI: 10.1080/0886022x.2022.2095287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background It is becoming increasingly evident that the accurate assessment of fluid
status is critical to ensure optimal care in patients undergoing
hemodialysis (HD). Various fluid parameters, including
overhydration (OH) and overhydration/extracellular water
(OH/ECW%), which can be obtained using a
bioimpedance spectroscopy device have been used to indicate the hydration
status in such patients. This study aimed to explore the effect of these
fluid parameters on cardiovascular events and determine which parameter was
a better predictor of cardiovascular events (CVEs). Methods A total of 227 patients who underwent HD at the Hangzhou Hospital of
Traditional Chinese Medicine were enrolled in this prospective study between
December 2017 and August 2018. Clinical data were collected, and the fluid
status of patients was assessed using a body composition monitor. The
patients were followed up until December 2020. The primary outcomes were
CVEs. The association between fluid parameters and CVEs was analyzed using
Cox proportional hazards models. The areas under the curve
(AUCs) of receiver operating characteristic analysis and
improvement in the global chi-squared value were used to compare the
predictive values of fluid parameters for CVEs. Results During a median follow-up of 31 months, 66 CVEs were recorded. The
patients with a higher absolute hydration index (OH) and a
relative hydration index (OH/ECW%) exhibited an
increased risk of developing CVEs. After adjusting for confounding factors,
both OH [hazard ratio (HR) 1.279 per L, 95%
confidence interval (CI) 1.047–1.562;
p = 0.016] and OH/ECW%
(HR 1.061 per %, 95% CI 1.017–1.108;
p = 0.006) were
independently associated with CVEs. The predictive ability of the absolute
hydration index was superior to the relative hydration index based on AUC
calculations for CVEs. Furthermore, a greater change in
χ2 in predicting CVEs was noted
for the absolute hydration index. Conclusions Both absolute hydration index and relative hydration index were found to be
independent predictors of CVEs in univariate and multivariate analyses.
Furthermore, the absolute hydration index had a better additive predictive
value than the relative hydration index in predicting CVEs.
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Affiliation(s)
- Linghong Cheng
- Department of Nephrology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Liyang Chang
- Department of Nephrology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Rongrong Tian
- Department of Nephrology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Jianfang Zhou
- Department of Nephrology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Fenxia Luo
- Department of Nephrology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Hongmei Zhang
- Department of Nephrology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
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Management of edema in pediatric nephrotic syndrome – Underfill or overfill? CURRENT PEDIATRICS REPORTS 2022. [DOI: 10.1007/s40124-022-00270-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Gonçalves MV, Ribeiro LR, Aquino J, Catto R, Nobre RK, Freitas RM, Barros RL, Böhlke M. Overhydration in acute kidney injury: Is it always a menace to critically ill patients? A survival study using bioimpedance spectroscopy. Clin Nutr ESPEN 2022; 49:499-503. [DOI: 10.1016/j.clnesp.2022.02.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 01/23/2022] [Accepted: 02/19/2022] [Indexed: 11/29/2022]
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16
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Orea-Tejeda A, Gómez-Martínez M, González-Islas D, Flores-Cisneros L, Keirns-Davis C, Sánchez-Santillán R, Pérez-García I, Martínez-Luna N, Robles-Hernández R, Sánchez-Moreno C, Orozco-Gutíerrez JJ. The impact of hydration status and fluid distribution on pulmonary function in COPD patients. Sci Rep 2022; 12:1216. [PMID: 35075255 PMCID: PMC8786821 DOI: 10.1038/s41598-022-05192-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 12/21/2021] [Indexed: 11/16/2022] Open
Abstract
Chronic Obstructive Pulmonary Disease (COPD) patients have alterations in body composition. Bioelectrical impedance analysis (BIA) evaluates body composition, hydration status, and fluid distribution. Subjects with fluid disturbances have been found to have lower FEV1, respiratory muscle strength, and poor prognosis. We aimed to evaluate the effect of hydration status and fluid distribution on pulmonary function in COPD patients. A cross-sectional study, 180 patients with a confirmed diagnosis of COPD were included. Patients with asthma, advanced renal or liver disease, acute HF, exacerbation of COPD, or pacemakers were excluded. Hydration status variables (TBW, ECW, ICW) and disturbance of fluid distribution [impedance ratio (IR) > 0.84 and phase angle (PhA)] were evaluated by BIA. Pulmonary function was assessed by spirometry. The mean population age was 71.55 ± 8.94 years; 55% were men. Subjects were divided into two groups according to the IR ≥ 0.84 or < 0.84. The group with higher IR ≥ 0.84 had lower FEV1, FVC, FEV1/FVC, DLCO and, PhA compared to those with IR < 0.84. After adjusting for confounding variables TBW, ECW, IR ≥ 0.84, PhA, and resistance/height increase were associated with decreased FEV1. In the same way, with IR ≥ 0.84, edema index ≥ 0.48, trunk and abdominal IR were negatively associated with FVC, and PhA had a positive association with FVC. Fluid distribution, especially IR and PhA, could be a useful parameter for predicting pulmonary function in COPD patients.
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Affiliation(s)
- Arturo Orea-Tejeda
- Heart Failure and Respiratory Distress Clinic, Cardiology Service at Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI, 14080, Del Tlalpan, Mexico City, Mexico
| | - Manuel Gómez-Martínez
- Heart Failure and Respiratory Distress Clinic, Cardiology Service at Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI, 14080, Del Tlalpan, Mexico City, Mexico
| | - Dulce González-Islas
- Heart Failure and Respiratory Distress Clinic, Cardiology Service at Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI, 14080, Del Tlalpan, Mexico City, Mexico.
| | - Laura Flores-Cisneros
- Department of Clinical Research at Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Candace Keirns-Davis
- Heart Failure and Respiratory Distress Clinic, Cardiology Service at Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI, 14080, Del Tlalpan, Mexico City, Mexico
| | - Rocío Sánchez-Santillán
- Heart Failure and Respiratory Distress Clinic, Cardiology Service at Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI, 14080, Del Tlalpan, Mexico City, Mexico
| | - Ilse Pérez-García
- Heart Failure and Respiratory Distress Clinic, Cardiology Service at Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI, 14080, Del Tlalpan, Mexico City, Mexico
| | - Nathalie Martínez-Luna
- Heart Failure and Respiratory Distress Clinic, Cardiology Service at Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI, 14080, Del Tlalpan, Mexico City, Mexico
| | - Robinson Robles-Hernández
- Heart Failure and Respiratory Distress Clinic, Cardiology Service at Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI, 14080, Del Tlalpan, Mexico City, Mexico
| | - Carlos Sánchez-Moreno
- Heart Failure and Respiratory Distress Clinic, Cardiology Service at Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI, 14080, Del Tlalpan, Mexico City, Mexico
| | - Juan José Orozco-Gutíerrez
- Heart Failure and Respiratory Distress Clinic, Cardiology Service at Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI, 14080, Del Tlalpan, Mexico City, Mexico
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Feasibility of bioimpedance spectroscopy and long-term functional assessment in critically ill children. Clin Nutr ESPEN 2022; 47:405-409. [PMID: 35063234 DOI: 10.1016/j.clnesp.2021.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 11/15/2021] [Accepted: 12/10/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND & AIMS Lean body mass loss due to critical illness in childhood could be detrimental to long term outcomes, including functional status and quality of life. We describe the feasibility of body composition assessment by bioimpedance spectroscopy (BIS) in the pediatric intensive care unit (PICU), and functional status and quality of life assessments up to 6 months following admission in a cohort of mechanically ventilated, critically ill children. METHODS We conducted a prospective, observational pilot study in a multidisciplinary PICU. Children aged 1 month to 18 years who required mechanical ventilation, with expected stay in the PICU of at least 5 days were included. We examined the feasibility of consenting, enrolling, and completing baseline and 6-month assessments of BIS variables, Functional Status Scale (FSS), and Pediatric Quality of Life (Peds QL), in eligible patients. RESULTS Of 32 patients approached, 23 (72%) completed baseline assessments [median (IQR) age 3.4 (1.0, 7.8) years, 14 (61%) male]; 6-month assessments were completed in 15 (65%) enrolled patients. Mean (SD) phase angle at study enrollment was 2.95 (0.93) and the impedance ratio was 0.90 (0.03). Phase angle (rs = -0.58, p = 0.03) and impedance ratio (rs = 0.61, p = 0.02) by BIS were significantly correlated with total FSS at PICU discharge. Median total FSS and FSS tech (feeding and respiratory domains of FSS) scores improved from enrollment [16 (13, 26) and 8 (7, 10)] to 6 months [6 (6, 9) and 2 (2, 4), respectively, p < 0.001]. Median Peds QL total, physical summary and psychosocial summary scores were not significantly different between PICU discharge and 6 months after PICU admission. Correlations between the total 6-month FSS and a) phase angle (-0.45, p = 0.197) and b) impedance ratio (0.56, p = 0.096) at PICU discharge were not significant. CONCLUSIONS We have demonstrated the feasibility of obtaining bedside BIS measurements in the PICU, and functional and quality of life assessments remotely following PICU discharge. Body composition and long-term assessment of functional outcomes and quality of life must be incorporated in nutrition trials in critically ill children.
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Yajima T, Yajima K, Takahashi H. Annual change in the extracellular fluid/intracellular fluid ratio and mortality in patients undergoing maintenance hemodialysis. Sci Rep 2022; 12:242. [PMID: 34997150 PMCID: PMC8741928 DOI: 10.1038/s41598-021-04366-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 12/20/2021] [Indexed: 11/09/2022] Open
Abstract
We aimed to investigate whether annual change in the extracellular fluid to intracellular fluid (ΔECF/ICF) ratio can accurately predict mortality in hemodialysis patients. Totally, 247 hemodialysis patients were divided into two groups according to the median baseline ECF/ICF ratio of 0.563 and ΔECF/ICF ≥ 0% or < 0% during the first year, respectively. Thereafter, they were divided into four groups according to each cutoff point and were followed up for mortality assessment. The ECF/ICF ratio increased from 0.566 ± 0.177 to 0.595 ± 0.202 in the first year (P = 0.0016). During the 3.4-year median follow-up, 93 patients died (42 cardiovascular-specific causes). The baseline ECF/ICF ≥ 0.563 and ΔECF/ICF ≥ 0% were independently associated with all-cause mortality (adjusted hazard ratio [aHR] 4.55, 95% confidence interval [CI] 2.60-7.98 and aHR 8.11, 95% CI 3.47-18.96, respectively). The aHR for ECF/ICF ≥ 0.563 and ΔECF/ICF ≥ 0% vs. ECF/ICF < 0.563 and ΔECF/ICF < 0% was 73.49 (95% CI 9.45-571.69). For model discrimination, adding the ΔECF/ICF (0.859) alone and both the baseline ECF/ICF and ΔECF/ICF (0.903) to the established risk model (0.746) significantly improved the C-index. Similar results were obtained for cardiovascular mortality. In conclusion, the ΔECF/ICF ratio could not only predict all-cause and cardiovascular mortality but also improve predictability of mortality in hemodialysis patients.
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Affiliation(s)
- Takahiro Yajima
- Department of Nephrology, Matsunami General Hospital, Gifu, 501-6062, Japan.
| | - Kumiko Yajima
- Department of Internal Medicine, Matsunami General Hospital, Gifu, 501-6062, Japan
| | - Hiroshi Takahashi
- Division of Medical Statistics, Fujita Health University School of Medicine, Aichi, 470-1192, Japan
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19
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Edwick DO, Hince DA, Rawlins JM, Wood FM, Edgar DW. Does electrical stimulation improve healing in acute minor burn injury, as measured by bioimpedance spectroscopy? A single center, randomized, controlled trial. BURNS OPEN 2022. [DOI: 10.1016/j.burnso.2021.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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20
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Sugizaki CSA, Queiroz NP, Silva DM, Freitas ATVS, Costa NA, Peixoto MRG. Comparison of Bioelectrical Impedance Vector Analysis (BIVA) to 7-point Subjective Global Assessment for the diagnosis of malnutrition. J Bras Nefrol 2021; 44:171-178. [PMID: 34590669 PMCID: PMC9269190 DOI: 10.1590/2175-8239-jbn-2021-0099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/31/2021] [Indexed: 01/07/2023] Open
Abstract
Introduction: Bioelectrical impedance vector analysis (BIVA) is a non-invasive and low-cost
strategy. The methods used to assess malnutrition in patients undergoing HD
are still a challenge. The aim of the present study was to compare BIVA to
7-Point Subjective Global Assessment (7-point SGA) to identify malnutrition.
We also investigated the sensitivity and specificity of the previously
proposed cutoffs point for BIVA parameters. Methods: Patients of both sexes, over 20 years of age, on HD treatment were included.
Anthropometric parameters, laboratory data, and bioelectrical impedance
analysis (BIA) were evaluated. Values of resistance (R) and reactance (Xc)
obtained by mono-frequency BIA were normalized to body height (H) to
generate a graph of the bioimpedance vector with the BIVA software. The
analysis of the area under the receiver operating curve ROC (AUC) was
performed. Results: Among the included 104 patients, the mean age was 51.70 (±15.10) years, and
52% were male. The BIVA had a sensitivity of 35% for diagnosing
malnutrition. The specificity of BIVA for identifying the well-nourished
patients was 85.7%. The diagnostic accuracy between the BIVA and 7-point SGA
was AUC=0.604; 95%CI 0.490-0.726, higher than the previously established
cutoff values (AUC=0.514; 95%CI: 0.369-0.631). The 95% confidence ellipses
did not overlap (p<0.05). Conclusion: Our study showed low accuracy of BIVA for diagnosing malnutrition using a
7-point SGA as a reference standard. However, it is a complementary method
for assessing nutritional status as it provides data on cellularity and
hydration, which are important aspects for the HD population.
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Affiliation(s)
- Clara S A Sugizaki
- Universidade Federal de Goiás, Faculdade de Nutrição, Programa de Pós-graduação Nutrição e Saúde, Goiânia, GO, Brasil
| | - Nayara P Queiroz
- Universidade Federal de Goiás, Faculdade de Nutrição, Programa de Pós-graduação Nutrição e Saúde, Goiânia, GO, Brasil
| | - Débora M Silva
- Universidade Federal de Goiás, Faculdade de Nutrição, Programa de Pós-graduação Nutrição e Saúde, Goiânia, GO, Brasil
| | - Ana T V S Freitas
- Universidade Federal de Goiás, Faculdade de Nutrição, Goiânia, GO, Brasil
| | - Nara A Costa
- Universidade Federal de Goiás, Faculdade de Nutrição, Goiânia, GO, Brasil
| | - Maria R G Peixoto
- Universidade Federal de Goiás, Faculdade de Nutrição, Goiânia, GO, Brasil
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21
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Smith-Ryan AE, Brewer G, Gould LM, Blue MNM, Hirsch KR, Greenwalt CE, Harrison C, Cabre HE, Ryan ED. Acute feeding has minimal effect on the validity of body composition and metabolic measures: dual-energy X-ray absorptiometry and a multi-compartment model. Br J Nutr 2021; 128:1-13. [PMID: 34392839 DOI: 10.1017/s0007114521003147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Understanding the effects of acute feeding on body composition and metabolic measures is essential to the translational component and practical application of measurement and clinical use. To investigate the influence of acute feeding on the validity of dual-energy X-ray absorptiometry (DXA), a four-compartment model (4C) and indirect calorimetry metabolic outcomes, thirty-nine healthy young adults (n 19 females; age: 21·8 (sd 3·1) years, weight; 71·5 (sd 10·0) kg) participated in a randomised cross-over study. Subjects were provided one of four randomised meals on separate occasions (high carbohydrate, high protein, ad libitum or fasted baseline) prior to body composition and metabolic assessments. Regardless of macronutrient content, acute feeding increased DXA percent body fat (%fat) for the total sample and females (average constant error (CE):-0·30 %; total error (TE): 2·34 %), although not significant (P = 0·062); the error in males was minimal (CE: 0·11 %; TE: 0·86 %). DXA fat mass (CE: 0·26 kg; TE: 0·75 kg) and lean mass (LM) (CE: 0·83 kg; TE: 1·23 kg) were not altered beyond measurement error for the total sample. 4C %fat was significantly impacted from all acute feedings (avg CE: 0·46 %; TE: 3·7 %). 4C fat mass (CE: 0·71 kg; TE: 3·38 kg) and fat-free mass (CE: 0·55 kg; TE: 3·05 kg) exceeded measurement error for the total sample. RMR was increased for each feeding condition (TE: 1666·9 kJ/d; 398 kcal/d). Standard pre-testing fasting guidelines may be important when evaluating DXA and 4C %fat, whereas additional DXA variables (fat mass and LM) may not be significantly impacted by an acute meal. Measuring body composition via DXA under less stringent pre-testing guidelines may be valid and increase feasibility of testing in clinical settings.
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Affiliation(s)
- Abbie E Smith-Ryan
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gabrielle Brewer
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lacey M Gould
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Malia N M Blue
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Katie R Hirsch
- Department of Geriatrics, Donald W. Reynolds Institute on Aging, Center for Translational Research in Aging & Longevity, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Casey E Greenwalt
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Courtney Harrison
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hannah E Cabre
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Eric D Ryan
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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22
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Hazara AM, Allgar V, Twiddy M, Bhandari S. A mixed-method feasibility study of a novel transitional regime of incremental haemodialysis: study design and protocol. Clin Exp Nephrol 2021; 25:1131-1141. [PMID: 34101030 PMCID: PMC8421284 DOI: 10.1007/s10157-021-02072-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 04/26/2021] [Indexed: 12/12/2022]
Abstract
Background Incremental haemodialysis/haemodiafiltration (HD) may help reduce early mortality rates in patients starting HD. This mixed-method feasibility study aims to test the acceptability, tolerance and safety of a novel incremental HD regime, and to study its impact on parameters of patient wellbeing.
Method We aim to enrol 20 patients who will commence HD twice-weekly with progressive increases in duration and frequency, achieving conventional treatment times over 15 weeks (incremental group). Participants will be followed-up for 6 months and will undergo regular tests including urine collections, bio-impedance analyses and quality-of-life questionnaires. Semi-structured interviews will be conducted to explore patients’ prior expectations from HD, their motivations for participation and experiences of receiving incremental HD. For comparison of safety and indicators of dialysis adequacy, a cohort of 40 matched patients who previously received conventional HD will be constructed from local dialysis records (historical controls).
Results Data will be recorded on the numbers screened and proportions consented and completing the study (primary outcome). Incremental and conventional groups will be compared in terms of differences in blood pressure control, interdialytic weight changes, indicators of dialysis adequacy and differences in adverse and serious adverse events. In analyses restricted to incremental group, measurements of RRF, fluid load and quality-of-life during follow-up will be compared with baseline values. From patient interviews, a narrative description of key themes along with anonymised quotes will be presented. Conclusion Results from this study will address a significant knowledge gap in the prescription HD therapy and inform the development novel future therapy regimens.
Supplementary Information The online version contains supplementary material available at 10.1007/s10157-021-02072-1.
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Affiliation(s)
- Adil M Hazara
- Hull York Medical School, Hull, UK. .,Hull University Teaching Hospitals NHS Trust, Anlaby Road, Hull, HU3 2JZ, UK.
| | - Victoria Allgar
- Peninsula Medical School, Faculty of Health, University of Plymouth, N15, ITTC Building 1, Plymouth Science Park, Plymouth, PL6 8BX, UK
| | - Maureen Twiddy
- Institute of Clinical and Applied Health Research, University of Hull, Hull, HU6 7RX, UK
| | - Sunil Bhandari
- Hull York Medical School, Hull, UK.,Hull University Teaching Hospitals NHS Trust, Anlaby Road, Hull, HU3 2JZ, UK
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23
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Phase angle cutoff value as a marker of the health status and functional capacity in breast cancer survivors. Physiol Behav 2021; 235:113400. [PMID: 33766604 DOI: 10.1016/j.physbeh.2021.113400] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/19/2021] [Accepted: 03/22/2021] [Indexed: 12/19/2022]
Abstract
Accurate predictive tools are key factors for cancer care. Phase angle (PhA) has been proposed as a marker of cellular health, particularly of cell-membrane integrity. Cutoff values have been proposed, including for cancer survivors. This study aimed to assess the usefulness of the proposed PhA cutoff, as a marker of bioelectrical impedance analysis (BIA) assessed health-status, and functional capacity in breast cancer (BC) survivors. This cross-sectional study included 25 women (50.6 ± 8.6 yrs) survivors of BC, divided into two groups according to the PhA reference value of 5.6° (group 1 [G1]: PhA ≤ 5.6° [n=13]; group 2 [G2]: PhA > 5.6° [n=12]) (Gupta et al. 2008). BIA-assessed health status parameters included: extracellular water (ECW), intracellular water (ICW), total body water (TBW), PhA, body mass, fat-free mass, muscle mass, body cell mass (BCM). Four functional tests were performed: 30 s chair-stand test, timed up and go test, ball throw test and 6-minute walking test. Results showed G2 had lower ECW/ICW ratio (p=0.001; ES=1.2), ECW/BCM ratio (p=0.001; ES=3.2) and ECW/TBW ratio (p=0.001; ES=4.8). There was no difference in functional capacity between groups. The results of the present study show that patients with higher PhA values have a higher ICW values and preservation in the ECW/ICW ratio, suggesting it's a better cell membrane quality and integrity. Relation of both PhA and cell membrane integrity with functional capacity warrants further research.
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24
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Bennet D, Khorsandian Y, Pelusi J, Mirabella A, Pirrotte P, Zenhausern F. Molecular and physical technologies for monitoring fluid and electrolyte imbalance: A focus on cancer population. Clin Transl Med 2021; 11:e461. [PMID: 34185420 PMCID: PMC8214861 DOI: 10.1002/ctm2.461] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/11/2021] [Accepted: 05/29/2021] [Indexed: 12/23/2022] Open
Abstract
Several clinical examinations have shown the essential impact of monitoring (de)hydration (fluid and electrolyte imbalance) in cancer patients. There are multiple risk factors associated with (de)hydration, including aging, excessive or lack of fluid consumption in sports, alcohol consumption, hot weather, diabetes insipidus, vomiting, diarrhea, cancer, radiation, chemotherapy, and use of diuretics. Fluid and electrolyte imbalance mainly involves alterations in the levels of sodium, potassium, calcium, and magnesium in extracellular fluids. Hyponatremia is a common condition among individuals with cancer (62% of cases), along with hypokalemia (40%), hypophosphatemia (32%), hypomagnesemia (17%), hypocalcemia (12%), and hypernatremia (1-5%). Lack of hydration and monitoring of hydration status can lead to severe complications, such as nausea/vomiting, diarrhea, fatigue, seizures, cell swelling or shrinking, kidney failure, shock, coma, and even death. This article aims to review the current (de)hydration (fluid and electrolyte imbalance) monitoring technologies focusing on cancer. First, we discuss the physiological and pathophysiological implications of fluid and electrolyte imbalance in cancer patients. Second, we explore the different molecular and physical monitoring methods used to measure fluid and electrolyte imbalance and the measurement challenges in diverse populations. Hydration status is assessed in various indices; plasma, sweat, tear, saliva, urine, body mass, interstitial fluid, and skin-integration techniques have been extensively investigated. No unified (de)hydration (fluid and electrolyte imbalance) monitoring technology exists for different populations (including sports, elderly, children, and cancer). Establishing novel methods and technologies to facilitate and unify measurements of hydration status represents an excellent opportunity to develop impactful new approaches for patient care.
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Affiliation(s)
- Devasier Bennet
- Center for Applied NanoBioscience and MedicineThe University of ArizonaCollege of MedicinePhoenixUSA
| | - Yasaman Khorsandian
- Center for Applied NanoBioscience and MedicineThe University of ArizonaCollege of MedicinePhoenixUSA
| | | | | | - Patrick Pirrotte
- Collaborative Center for Translational Mass SpectrometryTranslational Genomics Research InstitutePhoenixUSA
| | - Frederic Zenhausern
- Center for Applied NanoBioscience and MedicineThe University of ArizonaCollege of MedicinePhoenixUSA
- HonorHealth Research InstituteScottsdaleUSA
- Collaborative Center for Translational Mass SpectrometryTranslational Genomics Research InstitutePhoenixUSA
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25
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Elhassan MG, Chao PW, Curiel A. The Conundrum of Volume Status Assessment: Revisiting Current and Future Tools Available for Physicians at the Bedside. Cureus 2021; 13:e15253. [PMID: 34188992 PMCID: PMC8231469 DOI: 10.7759/cureus.15253] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Assessment of patients’ volume status at the bedside is a very important clinical skill that physicians need in many clinical scenarios. Hypovolemia with hypotension and tissue under-perfusion are usually more alarming to physicians, but hypervolemia is also associated with poor outcomes, making euvolemia a crucial goal in clinical practice. Nevertheless, the assessment of volume status can be challenging, especially in the absence of a gold standard test that is reliable and easily accessible to assist with clinical decision-making. Physicians need to have a broad knowledge of the individual non-invasive clinical tools available for them at the bedside to evaluate volume status. In this review, we will discuss the strengths and limitations of the traditional tools, which include careful history taking, physical examination, and basic laboratory tests, and also include the relatively new tool of point-of-care ultrasound.
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Affiliation(s)
| | - Peter W Chao
- Internal Medicine, Saint Agnes Medical Center, Fresno, USA
| | - Argenis Curiel
- Internal Medicine, Saint Agnes Medical Center, Fresno, USA
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26
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Caregiver burden in patients with moderate-severe cerebral palsy. The influence of nutritional status. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2021. [DOI: 10.1016/j.anpede.2020.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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27
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Accardi AJ, Matsubara BS, Gaw RL, Daleiden-Burns A, Heywood JT. Clinical Utility of Fluid Volume Assessment in Heart Failure Patients Using Bioimpedance Spectroscopy. Front Cardiovasc Med 2021; 8:636718. [PMID: 33898536 PMCID: PMC8060148 DOI: 10.3389/fcvm.2021.636718] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/12/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Bioimpedance spectroscopy (BIS) is a non-invasive method used to measure fluid volumes. In this report, we compare BIS measurements from patients with heart failure (HF) to those from healthy adults, and describe how these point-of-care fluid volume assessments may be applied to HF management. Methods and results: Fluid volumes were measured in 64 patients with NYHA class II or III HF and 69 healthy control subjects. BIS parameters including extracellular fluid (ECF), intracellular fluid (ICF), total body water (TBW), and ECF as a percentage of TBW (ECF%TBW) were analyzed. ECF%TBW values for the HF and control populations differed significantly (49.2 ± 3.2% vs. 45.2 ± 2.1%, respectively; p < 0.001); both distributions satisfied criteria for normality. Interquartile ranges did not overlap (46.7–51.0% vs. 43.8–46.4%, respectively; p < 0.001). Subgroup analyses of HF patients who underwent transthoracic echocardiography showed that impedance measurements correlated with inferior vena cava size (Pearson correlation −0.73, p < 0.0001). A case study is presented for illustrative purposes. Conclusions: BIS-measured ECF%TBW values were significantly higher in HF patients as compared to adults without HF. We describe three strata of ECF%TBW (normal, elevated, fluid overload) that may aid in clinical risk stratification and fluid volume monitoring of HF patients. Clinical Trial Registration: COMPARE – www.ClinicalTrials.gov; IMPEL – www.ClinicalTrials.gov; Heart Failure at Home – www.ClinicalTrials.gov, identifier: NCT02939053; NCT02857231; NCT04013373.
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Affiliation(s)
- Andrew J Accardi
- Department of Emergency Medicine, Scripps Memorial Hospital Encinitas, Encinitas, CA, United States
| | | | | | - Anne Daleiden-Burns
- Heart Failure Recovery and Research Program, Scripps Memorial Hospital La Jolla, La Jolla, CA, United States
| | - James Thomas Heywood
- Heart Failure Recovery and Research Program, Scripps Memorial Hospital La Jolla, La Jolla, CA, United States
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28
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Visceral fat reduction and increase of intracellular fluid in weight loss participants on antihypertension medication. Cardiovasc Endocrinol Metab 2021; 10:31-36. [PMID: 33634253 DOI: 10.1097/xce.0000000000000222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 06/09/2020] [Indexed: 11/25/2022]
Abstract
Objectives Complex physiological interactions between hypertension and obesity contribute to and perpetuate a heightened morbidity and mortality. With the prevalence of both hypertension and obesity reaching epidemic proportions, we asked whether antihypertensive medications affect the ability of participants to achieve the same level of body composition improvements as other participants in a comprehensive weight loss program focused on reduction of visceral adipose tissue. Methods Data was analyzed from 2200 subjects completing a commercially available, expert supervised weight loss program including ~6 weeks of a proprietary, nutritionally complete, very low-calorie diet (VLCD) followed by a ~3-week structured transition back to a normal dietary intake. Overall, 33% of the subjects reported taking at least one prescription antihypertensive medication. Results Our data show participants in both groups (± antihypertensive drugs) achieved clinically relevant and statistically significant improvements in standard measures of weight loss and endpoints directly related to inflammation and hypertension. Conclusion A nonpharmacologic, nonsurgical VLCD-based weight loss and metabolic health program is capable of producing clinically meaningful improvements in body composition and physiological endpoints, including those linked to hypertension, cardiovascular disease and inflammation, and is as equally effective for adults taking prescription antihypertensives as it is for those participants who are not.
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29
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Baki AH, Kamel CR, Mansour H. Are there any further modalities for prediction of subclinical volume overload in advanced stages of chronic kidney disease? Kidney Res Clin Pract 2021; 40:143-152. [PMID: 33789387 PMCID: PMC8041637 DOI: 10.23876/j.krcp.20.143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 11/29/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Subclinical volume overload in chronic kidney disease (CKD) patient represents a debatable issue. Although many tools were used to detect volume overload in such patients, many non-specific results were due to presence of comorbidities. Bioimpedance spectroscopy is an objective fluid status assessment method, which is shown superior to classical methods in many studies. Combining some of these tools may improve their accuracy and specificity. Inferior vena cava collapsibility index (IVCCI) with brain natriuretic peptide (BNP) can be combined for more specific volume assessment. This study was performed to assess the usage of combined IVCCI and BNP levels in CKD patients to predict subclinical volume overload. METHODS One hundred and ten patients with CKD (stages 4 and 5) not on dialysis and having normal left ventricular systolic function were included in this study. Exclusion criteria were: (1) patients with other causes of raised BNP than volume overload and (2) patients on diuretics. A complete medical history was obtained, and thorough examination and laboratory tests were performed for all included patients. IVCCI and BNP serum levels were evaluated. The patients who exhibited an overhydration (OH)/extracellular water (ECW) ratio of >15% were considered to have volume overload. RESULTS Twenty-six patients (23.6%) had subclinical hypervolemia as diagnosed by OH/ECW ratio of >15%. IVCCI ≤ 38% had higher diagnostic performance than BNP ≥ 24 pg/mL. Combining both IVCCI ≤ 38% and BNP ≥ 24 pg/mL increased the specificity and positive predictive value for detection of subclinical hypervolemia. CONCLUSION Combined elevated BNP level and decreased IVCCI are more precise tools for subclinical volume overload detection in CKD patients.
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Affiliation(s)
- Aber Halim Baki
- Department of Internal Medicine and Nephrology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Cherry Reda Kamel
- Department of Internal Medicine and Nephrology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Hazem Mansour
- Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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30
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Petrolo M, Rangelova E, Toilou M, Hammarqvist F. Body composition, muscle function and biochemical values in patients after pancreatic surgery: An observational study. Clin Nutr 2021; 40:4284-4289. [PMID: 33583661 DOI: 10.1016/j.clnu.2021.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 01/08/2021] [Accepted: 01/09/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND & AIMS The complex nature of pancreatic operation makes it a high-risk and technically demanding major abdominal procedure, resulting in early pathophysiological alterations. This study aims to observe changes in body composition, muscle function and biochemical values in patients during the early postoperative days (PODs) following pancreaticoduodenectomy or total pancreatectomy. METHODS Assessment of body composition by bioimpedance spectroscopy, muscle function by peak expiratory flow rate (PEFR) and maximum handgrip strength (HGS), and biochemical values were measured in patients the day before surgery and on PODs 3, 6 and 9. RESULTS Significant changes occurred among 34 patients on POD 3 in body weight +2.3 (0.8-3.6) kg, total body water +2.8 (1.1-5.9) L, extracellular water +2.5 (1.2-3.7) L, intracellular water +1.1 (-0.4-1.9) L, phase angle -1.0 (-1.2 to -0.7)°, PEFR -250.0 (-407.5 to -125.0) L/m and HGS -4.8 (-7.3 to -3.0) kg, C-reactive protein +78.0 (41.0-102.8) mg/L, haemoglobin -34.5 (-45.8 to -26.0) g/L, albumin -12 (-16.5 to -10.0) g/L. CONCLUSIONS Changes in water distribution, phase angle, initial reduced muscle function and altered biochemical values were observed during the first 9 PODs.
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Affiliation(s)
- Martina Petrolo
- Clinical Nutrition, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden.
| | - Elena Rangelova
- Clinical Investigation and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden; Department of Upper Abdominal Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Maria Toilou
- Clinical Nutrition, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden
| | - Folke Hammarqvist
- Department of Trauma and Acute Reparative Medicine, Karolinska University Hospital, CLINTEC, Karolinska Institute, Stockholm, Sweden
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31
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Yano M, Inoue A, Toda A, Takahashi M, Usami M, Hamada Y. Clinical characteristics of hyponatremia in patients receiving nutrition support : A cross-sectional study evaluated by bioelectrical impedance analysis. THE JOURNAL OF MEDICAL INVESTIGATION 2021; 68:112-118. [PMID: 33994454 DOI: 10.2152/jmi.68.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Background & aims : We investigated the contributing factors of hyponatremia in patients on nutrition support using bioelectrical impedance analysis (BIA). Methods : Thirty patients administered enteral or parenteral nutrition support for at least 72 hours were studied. We collected nutritional and electrolyte intake, serum biochemical parameters, and body composition measured by BIA. Patients were classified into two groups according to their serum sodium levels : (1) Normanatremia group, 135-145 mEq / L (n = 18) and (2) Hyponatremia group, less than 135 mEq / L (n = 12), and their characteristics were analyzed. Results : There were no significant differences between the Normonatremia and Hyponatremia groups in terms of energy, protein, and sodium intake. Serum biochemical parameters other than serum sodium and chloride levels were comparable between the two groups. On the other hand, the ratio of extracellular water to total body water (ECW / TBW) obtained by BIA was significantly higher in the Hyponatremia group than in the Normonatremia group. Further, an elevated ECW / TBW significantly and negatively correlated with serum albumin level. Conclusions : Regardless of sodium intake, higher ECW / TBW was associated with hyponatremia in patients on nutrition support. ECW / TBW may be an important clinical parameter relevant to the nutritional care of hyponatremia. J. Med. Invest. 68 : 112-118, February, 2021.
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Affiliation(s)
- Mayumi Yano
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Arisa Inoue
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Akiyo Toda
- Department of Clinical Nutrition and Dietetics, Konan Women's University, Kobe, Japan
| | - Michiko Takahashi
- Department of Nutrition, Division of Diabetes and Endocrinology Department of Internal Medicine, Kobe University Hospital, Kobe, Japan
| | - Makoto Usami
- Department of Clinical Nutrition and Dietetics, Konan Women's University, Kobe, Japan
| | - Yasuhiro Hamada
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
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32
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Edwick DO, Hince DA, Rawlins JM, Wood FM, Edgar DW. Alternate Electrode Positions for the Measurement of Hand Volumes Using Bioimpedance Spectroscopy. Lymphat Res Biol 2020; 18:560-571. [DOI: 10.1089/lrb.2019.0078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Affiliation(s)
- Dale O. Edwick
- State Adult Burns Unit, Fiona Stanley Hospital, Murdoch, Australia
- School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Australia
- Fiona Wood Foundation, Fiona Stanley Hospital, Murdoch, Australia
| | - Dana A. Hince
- Institute of Health Research, The University of Notre Dame Australia, Fremantle, Australia
| | - Jeremy M. Rawlins
- State Adult Burns Unit, Fiona Stanley Hospital, Murdoch, Australia
- Department of Plastic and Maxillofacial Surgery, Royal Perth Hospital, Perth, Australia
| | - Fiona M. Wood
- State Adult Burns Unit, Fiona Stanley Hospital, Murdoch, Australia
- Fiona Wood Foundation, Fiona Stanley Hospital, Murdoch, Australia
- Burn Injury Research Unit, The University of Western Australia, Nedlands, Australia
| | - Dale W. Edgar
- State Adult Burns Unit, Fiona Stanley Hospital, Murdoch, Australia
- Fiona Wood Foundation, Fiona Stanley Hospital, Murdoch, Australia
- Institute of Health Research, The University of Notre Dame Australia, Fremantle, Australia
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Low Intracellular Water, Overhydration, and Mortality in Hemodialysis Patients. J Clin Med 2020; 9:jcm9113616. [PMID: 33182670 PMCID: PMC7697083 DOI: 10.3390/jcm9113616] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/28/2020] [Accepted: 11/06/2020] [Indexed: 12/22/2022] Open
Abstract
Background: In hemodialysis patients, extracellular water (ECW) overload predicts all-cause and cardiovascular mortality. The primary aim of the present study was to analyze changes in post-dialysis (i.e., following removal of excess ECW) ECW, intracellular water (ICW), and the overhydration (OH) parameter over time. Additionally, the association of these parameters with mortality was explored. Patients and methods: Prospective study of prevalent hemodialysis patients (n = 124) followed for a median of 20 (interquartile range (IQR) 8–31) months. In three visits, inflammation (C-reactive protein) and post-dialysis fluid status (bioimpedance, BIS) were assessed. Results: During follow-up, the overhydration (OH) parameter increased (−0.696 ± 1.6 vs. 0.268 ± 1.7 L; p = 0.007) at the expense of a decrease in intracellular water (ICW) (19.90 ± 4.5 vs. 18.72 ± 4.1 24 L; p = 0.006) with a non-significant numerical increase in ECW/ICW ratio (0.795 ± 0.129 vs. 0.850 ± 0.143; p = 0.055). Baseline ICW positively correlated with muscle mass and energy intake and negatively with C-reactive protein and it was lower in those who died than in survivors (15.09 ± 2.36 vs. 18.87 ± 4.52 L; p = 0.004). In Kaplan–Meier analysis, patients with low baseline ICW (≤17 L) and high ECW/ICW ratio (≥0.84) were at an increased risk of death. Baseline ICW was also associated with the risk of death in adjusted Cox proportional hazards models (HR 0.62 (0.40–0.98) p = 0.04). Conclusions: In hemodialysis patients, the post-dialysis OH parameter increased over time while ICW decreased, without changes in ECW. Low baseline post-dialysis ICW correlated with muscle wasting and inflammation and was an independent risk factor for mortality.
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The Effects of Thermal Water Physical Exercise in Patients with Lower Limb Chronic Venous Insufficiency Monitored by Bioimpedance Analysis. Diagnostics (Basel) 2020; 10:diagnostics10110889. [PMID: 33142741 PMCID: PMC7694156 DOI: 10.3390/diagnostics10110889] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 10/28/2020] [Accepted: 10/29/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Lower limb chronic venous diseases (CVD) lead to possible edema. The aim of the present investigation was to study the effect of thermal aquatic standardize exercise on lower limb edema control in CVD patients assessed by bioimpedance analysis (BIA). METHODS Seventeen patients (34 legs) affected by CVD clinical class CEAP C3, 4c, Ep, As, Pr were included. All the cohort performed a standardized exercise protocol in thermal water environment for a total of five sessions. BIA, leg volume, and heart rate at rest were measured. RESULTS After the five exercise sessions, BIA showed a significant percentage of extracellular water (ECW) reduction from 42.1 ± 5.8 to 41.24 ± 5.5%; p < 0.001. Moreover, an improvement of resistance (p < 0.0009) and reactance (p < 0.009) was assessed. At the same time, the leg volume reduction rate was 15.7%, p <0.0001. A moderate-strong correlation was found between % ECW and leg volume variation (R = 0.59, p < 0.01). Finally, a significant HR at rest reduction was recorded, p < 0.0001. CONCLUSION The investigated exercise protocol significantly affects the lower limb volume, and BIA parameters related to the tissue drainage improvement. The correlation founded between the ECW rate and volume variations suggest the possible use of BIA as a biomarker for monitoring the treatments aimed to reduce edema in CVD.
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Five-component model validation of reference, laboratory and field methods of body composition assessment. Br J Nutr 2020; 125:1246-1259. [PMID: 32921319 DOI: 10.1017/s0007114520003578] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
This study reports the validity of body fat percentage (BF%) estimates from several commonly employed techniques as compared with a five-component (5C) model criterion. Healthy adults (n 170) were assessed by dual-energy X-ray absorptiometry (DXA), air displacement plethysmography (ADP), multiple bioimpedance techniques and optical scanning. Output was also used to produce a criterion 5C model, multiple variants of three- and four-component models (3C; 4C) and anthropometry-based BF% estimates. Linear regression, Bland-Altman analysis and equivalence testing were performed alongside evaluation of the constant error (CE), total error (TE), se of the estimate (SEE) and coefficient of determination (R2). The major findings were (1) differences between 5C, 4C and 3C models utilising the same body volume (BV) and total body water (TBW) estimates are negligible (CE ≤ 0·2 %; SEE < 0·5 %; TE ≤ 0·5 %; R2 1·00; 95 % limits of agreement (LOA) ≤ 0·9 %); (2) moderate errors from alternate TBW or BV estimates in multi-component models were observed (CE ≤ 1·3 %; SEE ≤ 2·1 %; TE ≤ 2·2 %; R2 ≥ 0·95; 95 % LOA ≤ 4·2 %); (3) small differences between alternate DXA (i.e. tissue v. region) and ADP (i.e. Siri v. Brozek equations) estimates were observed, and both techniques generally performed well (CE < 3·0 %; SEE ≤ 2·3 %; TE ≤ 3·6 %; R2 ≥ 0·88; 95 % LOA ≤ 4·8 %); (4) bioimpedance technologies performed well but exhibited larger individual-level errors (CE < 1·0 %; SEE ≤ 3·1 %; TE ≤ 3·3 %; R2 ≥ 0·94; 95 % LOA ≤ 6·2 %) and (5) anthropometric equations generally performed poorly (CE 0·6- 5·7 %; SEE ≤ 5·1 %; TE ≤ 7·4 %; R2 ≥ 0·67; 95 % LOA ≤ 10·6 %). Collectively, the data presented in this manuscript can aid researchers and clinicians in selecting an appropriate body composition assessment method and understanding the associated errors when compared with a reference multi-component model.
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Martínez de Zabarte Fernández JM, Ros Arnal I, Peña Segura JL, García Romero R, Rodríguez Martínez G. [Caregiver burden in patients with moderate-severe cerebral palsy. The influence of nutritional status]. An Pediatr (Barc) 2020; 94:311-317. [PMID: 32828712 DOI: 10.1016/j.anpedi.2020.06.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/31/2020] [Accepted: 06/23/2020] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Patients with moderate-severe cerebral palsy require the support of their caregivers to carry out the activities of daily living (ADLs). OBJECTIVES To describe the comorbidities, need for care in children with cerebral palsy and to analyse the influence of the degree of motor involvement, nutritional status and other neurological disorders. METHODS Cross-sectional and observational study. Patients with cerebral palsy degrees III-IV-V according to the Gross Motor Function Classification System (GMFCS) have been studied. A record of comorbidities has been made and body composition has been studied using anthropometry and bioimpedance. In addition, a caregiver burden survey on ADLs has been carried out (10 items on the different actions: hygiene, clothing, transfers, sleeping and feeding). Which variables have the greatest influence on the perception of difficulty in performing ADLs have been studied. RESULTS A total of 69 patients (50.7% women, mean age 10.46 ± 0.4 years) were analysed, with GMFCS grades: grade III 36.2% (N=25), grade IV 29.0% (N=20), grade V 34.8% (N=24). A relationship was found between the caregiver burden score and GMFCS grade (P=0.003) and intellectual disability (P<0.001). However, regardless of the degree of GMFCS and intellectual disability, there is greater difficulty in performing ADLs in relation to lower values in weight (Z-score) (P=0.028), fat mass (kg) (P=0.035), fat mass (%) (P=0.094), body mass index (Z-score) (P=0.086). CONCLUSIONS In addition to the degree of clinical impairment, nutritional status is a factor that influences the caregiver's difficulty in performing the ADLs in cerebral palsy patients on which we can act to improve this problem.
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Affiliation(s)
| | - Ignacio Ros Arnal
- Unidad de Gastroenterología y Nutrición Pediátrica, Hospital Universitario Miguel Servet, Zaragoza, España
| | | | - Ruth García Romero
- Unidad de Gastroenterología y Nutrición Pediátrica, Hospital Universitario Miguel Servet, Zaragoza, España
| | - Gerardo Rodríguez Martínez
- Universidad de Zaragoza, Instituto de Investigación Sanitaria Aragón, Red de Salud Materno Infantil y del Desarrollo (SAMID), RETICS ISCIII, Zaragoza, España
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Fetterplace K, Ridley EJ, Beach L, Abdelhamid YA, Presneill JJ, MacIsaac CM, Deane AM. Quantifying Response to Nutrition Therapy During Critical Illness: Implications for Clinical Practice and Research? A Narrative Review. JPEN J Parenter Enteral Nutr 2020; 45:251-266. [PMID: 32583880 DOI: 10.1002/jpen.1949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 06/17/2020] [Indexed: 11/09/2022]
Abstract
Critical illness causes substantial muscle loss that adversely impacts recovery and health-related quality of life. Treatments are therefore needed that reduce mortality and/or improve the quality of survivorship. The purpose of this Review is to describe both patient-centered and surrogate outcomes that quantify responses to nutrition therapy in critically ill patients. The use of these outcomes in randomized clinical trials will be described and the strengths and limitations of these outcomes detailed. Outcomes used to quantify the response of nutrition therapy must have a plausible mechanistic relationship to nutrition therapy and either be an accepted measure for the quality of survivorship or highly likely to lead to improvements in survivorship. This Review identified that previous trials have utilized diverse outcomes. The variety of outcomes observed is probably due to a lack of consensus as to the most appropriate surrogate outcomes to quantify response to nutrition therapy during research or clinical practice. Recent studies have used, with some success, measures of muscle mass to evaluate and monitor nutrition interventions administered to critically ill patients.
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Affiliation(s)
- Kate Fetterplace
- Department of Allied Health (Clinical Nutrition), Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Melbourne Medical School, Department of Medicine and Radiology, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Emma J Ridley
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Nutrition Department, The Alfred Hospital, Commercial Road, Melbourne, Australia
| | - Lisa Beach
- Department of Allied Health (Physiotherapy), Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Yasmine Ali Abdelhamid
- Melbourne Medical School, Department of Medicine and Radiology, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.,Intensive Care Unit, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Jeffrey J Presneill
- Melbourne Medical School, Department of Medicine and Radiology, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.,Intensive Care Unit, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Christopher M MacIsaac
- Melbourne Medical School, Department of Medicine and Radiology, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.,Intensive Care Unit, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Adam M Deane
- Melbourne Medical School, Department of Medicine and Radiology, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.,Intensive Care Unit, Royal Melbourne Hospital, Parkville, Victoria, Australia
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Resistance exercise and breast cancer-related lymphedema-a systematic review update and meta-analysis. Support Care Cancer 2020; 28:3593-3603. [PMID: 32415386 PMCID: PMC7316683 DOI: 10.1007/s00520-020-05521-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 05/06/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND The purpose of this systematic review update and meta-analysis was to analyze resistance exercise (RE) intervention trials in breast cancer survivors (BCS) regarding their effect on breast cancer-related lymphedema (BCRL) status and upper and lower extremity strength. METHODS Systematic literature search was conducted utilizing PubMed, MEDLINE, and Embase databases. Any exercise intervention studies-both randomized controlled and uncontrolled-which assessed the effects of RE on BCRL in BCS in at least one intervention group published between 1966 and 31st January 2020 were included. Included articles were analyzed regarding their level of evidence and their methodological quality using respective tools for randomized and nonrandomized trials of the Cochrane collaboration. Meta-analysis for bioimpedance spectroscopy (BIS) values as well as upper and lower extremity strength was conducted. RESULTS Altogether, 29 studies were included in the systematic review. Results of six studies with altogether twelve RE intervention groups could be pooled for meta-analysis of the BCRL. A significant reduction of BCRL after RE was seen in BIS values (95% CI - 1.10 [- 2.19, - 0.01] L-Dex score). Furthermore, strength results of six studies could be pooled and meta-analysis showed significant improvements of muscular strength in the upper and lower extremities (95% CI 8.96 [3.42, 14.51] kg and 95% CI 23.42 [11.95, 34.88] kg, respectively). CONCLUSION RE does not have a systematic negative effect on BCRL and, on the contrary, potentially decreases it.
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Jaques DA, Davenport A. Determinants of volume status in peritoneal dialysis: A longitudinal study. Nephrology (Carlton) 2020; 25:785-791. [PMID: 32304154 DOI: 10.1111/nep.13716] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 04/04/2020] [Accepted: 04/07/2020] [Indexed: 01/12/2023]
Abstract
AIM In peritoneal dialysis (PD), fluid overload is frequent and associated with cardiac dysfunction and mortality. As it is considered a modifiable risk factor, we wished to describe clinical determinants of fluid overload in a longitudinal cohort of PD outpatients. METHODS We consecutively included PD outpatients treated with continuous ambulatory PD (CAPD) or automated PD (APD) attending for their routine clinical visit at a single tertiary hospital. Extracellular water (ECW) to total body water (TBW) ratio was measured by multifrequency bioelectrical impedance. Peritoneal transport characteristics were measured with a standard peritoneal equilibration test. Patients had a second follow-up visit with the same measurements. Univariable and multivariable mixed linear regression models were conducted with ECW/TBW as the dependent variable. RESULTS A total of 155 patients were enrolled with a median follow-up time of 12 months. Median dialysis vintage was 13.5 ± 3.4 months. Overall mean value of ECW/TBW was 39.3% ± 1.1. In multivariable analysis, factors positively associated with ECW/TBW were: Age (P < .001), diabetes (P = .002), and SBP (P = .028). Factors negatively associated with ECW/TBW were: nPNA (P = .001), serum albumin (P < .001) and PTH (P = .014). None of the considered variable showed a significant interaction with time. CONCLUSION We confirm a high prevalence of fluid overload in PD patients and show that it is strongly associated with older age, diabetes, hypoalbuminemia and protein energy wasting. In contrast, when PD prescription is tailored to patient's individual characteristics, residual renal function, PD modality and peritoneal characteristics are not decisive in controlling volume status.
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Affiliation(s)
- David A Jaques
- Department of Nephrology, Geneva University Hospitals, Geneva, Switzerland.,UCL Department of Nephrology, Royal Free London NHS Foundation Trust, London, UK
| | - Andrew Davenport
- UCL Department of Nephrology, Royal Free London NHS Foundation Trust, London, UK
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Martínez de Zabarte Fernández JM, Ros Arnal I, Peña Segura JL, García Romero R, Rodríguez Martínez G. Nutritional status of a population with moderate-severe cerebral palsy: Beyond the weight. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2020. [DOI: 10.1016/j.anpede.2019.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Martínez de Zabarte Fernández JM, Ros Arnal I, Peña Segura JL, García Romero R, Rodríguez Martínez G. Situación nutricional en una población con parálisis cerebral moderada-grave: más allá del peso. An Pediatr (Barc) 2020; 92:192-199. [DOI: 10.1016/j.anpedi.2019.06.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 05/21/2019] [Accepted: 06/12/2019] [Indexed: 11/15/2022] Open
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Combined Predictive Value of Extracellular Fluid/Intracellular Fluid Ratio and the Geriatric Nutritional Risk Index for Mortality in Patients Undergoing Hemodialysis. Nutrients 2019; 11:nu11112659. [PMID: 31690024 PMCID: PMC6893674 DOI: 10.3390/nu11112659] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 10/14/2019] [Accepted: 11/01/2019] [Indexed: 01/19/2023] Open
Abstract
The ratio of extracellular fluid (ECF) to intracellular fluid (ICF) may be associated with mortality in patients undergoing hemodialysis, possibly associated with protein-energy wasting. We therefore investigated the relationship of the ECF/ICF ratio and the geriatric nutritional risk index (GNRI) with the all-cause and cardiovascular-specific mortality in 234 patients undergoing hemodialysis. Bioimpedance analysis of the ECF and ICF was performed and the ECF/ICF ratio was independently associated with GNRI (β = −0.247, p < 0.0001). During a median follow-up of 2.8 years, 72 patients died, of which 29 were cardiovascular. All-cause mortality was independently associated with a lower GNRI (adjusted hazard ratio [aHR] 3.48, 95% confidence interval [CI] 2.01–6.25) and a higher ECF/ICF ratio (aHR 11.38, 95%CI 5.29–27.89). Next, we divided patients into four groups: group 1 (G1), higher GNRI and lower ECF/ICF ratio; G2, lower GNRI and lower ECF/ICF ratio; G3, higher GNRI and higher ECF/ICF ratio; and G4, lower GNRI and higher ECF/ICF ratio. Analysis of these groups revealed 10-year survival rates of 91.2%, 67.2%, 0%, and 0% in G1, G2, G3, and G4, respectively. The aHR for G4 versus G1 was 43.4 (95%CI 12.2–279.8). Adding the GNRI alone, the ECF/ICF ratio alone, or both to the established risk model improved the net reclassification improvement by 0.444, 0.793 and 0.920, respectively. Similar results were obtained for cardiovascular mortality. In conclusion, the ECF/ICF ratio was independently associated with GNRI and could predict mortality in patients undergoing hemodialysis. Combining the GNRI and ECF/ICF ratio could improve mortality predictions.
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Barone M, Viggiani MT, Introna A, D'errico E, Scarafino A, Iannone A, Di Leo A, Simone IL. Nutritional prognostic factors for survival in amyotrophic lateral sclerosis patients undergone percutaneous endoscopic gastrostomy placement. Amyotroph Lateral Scler Frontotemporal Degener 2019; 20:490-496. [PMID: 31347407 DOI: 10.1080/21678421.2019.1643374] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Objective: There are conflicting data on nutritional factors influencing survival in amyotrophic lateral sclerosis (ALS) patients after percutaneous endoscopic gastrostomy (PEG) placement. We performed an observational cross-sectional study evaluating body mass index (BMI) categories and cholesterol levels as prognostic factors for survival after PEG. Moreover, we assessed body composition in a subgroup of patients to better explain the influence of BMI on survival. Methods: Neurological and nutritional parameters were evaluated at the time of PEG implantation in 47 consecutive patients. Moreover, body composition was evaluated in a subgroup of 22 patients by bioelectrical impedance analysis. Survival was calculated as the time from the PEG placement to death. Results: Underweight patients had a significantly increased risk of death as compared to normal-weight patients using Cox regression analysis [HR = 3.37 (1.29-8.81); p = 0.04]. Similarly, older age at the onset of symptoms significantly increased the risk of death [HR = 1.07 (1.02-1.12); p = 0.001]. Neither overweight/obesity nor hypercholesterolemia affected survival. All ALS patients showed an altered body composition compared to the general population. In addition, a BMI <18.5 kg/m2 identified patients with a significant reduction of body cell mass (BCM) and phase angle (PhA) compared to patients with normal BMI taken as the reference value. Conclusions: In the later stages of the disease, only a BMI < 18.5 kg/m2 and older age at symptom onset had a prognostic value on survival. Dyslipidemia did not affect survival. The low BCM and PhA characterizing underweight patients support the role of BMI as a predictor of survival.
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Affiliation(s)
- Michele Barone
- Department of Emergency and Organ Transplantation, Gastroenterology Unit, University of Bari , Bari , Italy
| | - Maria Teresa Viggiani
- Department of Emergency and Organ Transplantation, Gastroenterology Unit, University of Bari , Bari , Italy
| | - Alessandro Introna
- Neurological ALS Tertiary Centre, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari , Bari , Italy
| | - Eustachio D'errico
- Neurological ALS Tertiary Centre, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari , Bari , Italy
| | - Antonio Scarafino
- Neurological ALS Tertiary Centre, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari , Bari , Italy
| | - Andrea Iannone
- Department of Emergency and Organ Transplantation, Gastroenterology Unit, University of Bari , Bari , Italy
| | - Alfredo Di Leo
- Department of Emergency and Organ Transplantation, Gastroenterology Unit, University of Bari , Bari , Italy
| | - Isabella Laura Simone
- Neurological ALS Tertiary Centre, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari , Bari , Italy
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Amano K, Liu D, Bruera E, Hui D. Collapse of Fluid Balance and Association with Survival in Patients with Advanced Cancer Admitted to a Palliative Care Unit: Preliminary Findings. J Palliat Med 2019; 23:459-465. [PMID: 31657649 DOI: 10.1089/jpm.2019.0392] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background: Few studies have investigated water balance as a predictor of survival in cancer patients in the last days of life. Objective: To examine the association between extracellular water (ECW), intracellular water (ICW), ratio of ECW to ICW (ECW/ICW), and survival in nonedematous and edematous patients with advanced cancer admitted to a palliative care unit. Design: A prospective observational study. Setting/Subjects: Patients with advanced cancer admitted to a palliative care unit. Measurements: Upon enrollment, bioelectrical impedance analysis was used to assess ECW, ICW, and body composition. We conducted time-to-event analyses using the Kaplan-Meier method, log-rank test, and univariate and multivariate Cox regression analyses. Results: A total of 190 of 204 patients who participated in this study had ICW and ECW measures available for analysis. The median survival was 10 days (95% confidence interval [CI] 9-12) days. The median ECW, ICW, and ECW/ICW were 18.9 L, 19.1 L, and 1.0 for 72 nonedematous patients, and 21.9 L, 20.1 L, and 1.1 for 118 edematous patients, respectively. In univariate Cox regression analysis, ICW ≤20 L was associated with a shorter survival in the nonedematous patients (hazard ratio [HR] 1.92, 95% CI 1.10-3.34, p = 0.02) and a longer survival in the edematous patients (HR 0.61, 95% CI 0.41-0.90, p = 0.01). In multivariable analysis, ICW (≤20 L vs. >20 L) remained an independent prognostic factor in edematous patients (HR 0.64, 95% CI 0.43-0.95, p = 0.03). Conclusions: Greater ICW was an independent predictor of poorer survival in cancer patients with edema in the last days of life.
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Affiliation(s)
- Koji Amano
- Department of Palliative Medicine, Osaka City General Hospital, Osaka City, Japan
| | - Diane Liu
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Eduardo Bruera
- Department of Palliative Care, Rehabilitation and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - David Hui
- Department of Palliative Care, Rehabilitation and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas
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Lueck S, Preusse C, Delis A, Schaefer M. Development of cell oedema in piglet hearts during ischaemia monitored by dielectric spectroscopy. Bioelectrochemistry 2019; 129:54-61. [DOI: 10.1016/j.bioelechem.2019.04.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 04/29/2019] [Accepted: 04/29/2019] [Indexed: 11/30/2022]
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Assessment of Body Composition in Health and Disease Using Bioelectrical Impedance Analysis (BIA) and Dual Energy X-Ray Absorptiometry (DXA): A Critical Overview. CONTRAST MEDIA & MOLECULAR IMAGING 2019; 2019:3548284. [PMID: 31275083 PMCID: PMC6560329 DOI: 10.1155/2019/3548284] [Citation(s) in RCA: 154] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 05/05/2019] [Indexed: 12/18/2022]
Abstract
The measurement of body composition (BC) represents a valuable tool to assess nutritional status in health and disease. The most used methods to evaluate BC in the clinical practice are based on bicompartment models and measure, directly or indirectly, fat mass (FM) and fat-free mass (FFM). Bioelectrical impedance analysis (BIA) and dual energy X-ray absorptiometry (DXA) (nowadays considered as the reference technique in clinical practice) are extensively used in epidemiological (mainly BIA) and clinical (mainly DXA) settings to evaluate BC. DXA is primarily used for the measurements of bone mineral content (BMC) and density to assess bone health and diagnose osteoporosis in defined anatomical regions (femur and spine). However, total body DXA scans are used to derive a three-compartment BC model, including BMC, FM, and FFM. Both these methods feature some limitations: the accuracy of BIA measurements is reduced when specific predictive equations and standardized measurement protocols are not utilized whereas the limitations of DXA are the safety of repeated measurements (no more than two body scans per year are currently advised), cost, and technical expertise. This review aims to provide useful insights mostly into the use of BC methods in prevention and clinical practice (ambulatory or bedridden patients). We believe that it will stimulate a discussion on the topic and reinvigorate the crucial role of BC evaluation in diagnostic and clinical investigation protocols.
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47
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Martins PC, Hansen F, Silva AM, Silva DAS. Fluid distribution and cell integrity indicators evaluated by bioelectrical impedance in university athletes: comparison between team sports and individual sports. Physiol Meas 2019; 40:015004. [PMID: 30557857 DOI: 10.1088/1361-6579/aaf8cd] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To compare indicators of fluid distribution and cellular integrity in university athletes through a cross-sectional study of 167 university athletes (18-35 years) who competed in team sports and individual sports. APPROACH Bioimpedance was used to estimate total body water (TBW), intracellular water (ICW), extracellular water (ECW), ECW/ICW ratio, impedance (Z), reactance (Xc), resistance (R), phase angle, body cell mass (BCM) and ECW/BCM ratio at a frequency of 50 kHz. X-ray absorptiometry was used to determine lean soft tissue mass and body fat. As covariables, sex, age, time of practice and type of modality were obtained by questionnaire. MAIN RESULTS Individual male athletes presented higher values of ECW/ICW ratio (means difference MD = 0.006, p = 0.020) and ECW/BCM ratio (MD = 0.006, p = 0.017) than team sports male athletes. Values of Z (MD = 24.988, p = 0.009), Xc (MD = 3.327, p = 0.008) and R (MD = 24.755, p = 0.09) were higher in male athletes practicing team sports than individual sports. Female team sports athletes presented higher values of Z (MD = 32.029, p = 0.015) and R (MD = 31.987, p = 0.015) than individual female athletes. It was concluded that ECW/ICW and ECW/BCM ratios were higher in male athletes who practiced individual sports. For the Z, R, and Xc values, the athletes in team sports presented higher values. The female athletes who practiced team sports presented higher values of Z and R than did individual female athletes. SIGNIFICANCE ECW/ICW and ECW/BCM ratios were higher in male athletes who practiced individual sports. For the Z, R, and Xc values, the athletes in team sports presented higher values. The female athletes who practiced team sports presented higher values of Z and R than did individual female athletes.
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Affiliation(s)
- Priscila Custódio Martins
- Federal University of Santa Catarina, Research Center in Kinanthropometry and Human Performance, Florianópolis, Brazil. Federal University of Santa Catarina, Research Center in Kinanthropometry and Human Performance, Sports Centre, University Campus, Trindade, 88040-900 Florianópolis, Santa Catarina, Brazil. Author to whom any correspondence should be addressed
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Chen WL, Lai HY, Chen PY, Kan CD, Lin CH. Hypervolemia Screening for Dialysis Patient Healthcare Using Meta Learning Model-Based Intelligent Scaler. SMART SCIENCE 2019. [DOI: 10.1080/23080477.2018.1517293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Wei-Ling Chen
- KSVGH Originals & Enterprises and Department of Engineering and Maintenance, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
| | - Hsiang-Yueh Lai
- Department of Electrical Engineering, National Chin-Yi University of Technology, Taichung City, Taiwan
| | - Pi-Yun Chen
- Department of Electrical Engineering, National Chin-Yi University of Technology, Taichung City, Taiwan
| | - Chung-Dann Kan
- Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Chia-Hung Lin
- Department of Electrical Engineering, National Chin-Yi University of Technology, Taichung City, Taiwan
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Becroft L, Ooi G, Forsyth A, King S, Tierney A. Validity of multi-frequency bioelectric impedance methods to measure body composition in obese patients: a systematic review. Int J Obes (Lond) 2018; 43:1497-1507. [PMID: 30568268 DOI: 10.1038/s41366-018-0285-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 08/15/2018] [Accepted: 11/28/2018] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Excessive lean tissue loss following bariatric surgery may pose serious metabolic consequences. Accurate methods to assess body composition following bariatric surgery are required. This review aimed to investigate if multi-frequency bioelectric impedance (MF-BI) is a valid tool to determine body composition in obese patients. METHODS MEDLINE, EMBASE, CINAHL and CENTRAL databases were searched until March 2017. Included studies were published in English with obese (body mass index (BMI) ≥ 30 kg/m2) adults measuring body composition with MF-BI methods in comparison with reference methods. Exclusions were pregnancy, animal studies, non-English language studies, single frequency BI. A total of 6395 studies were retrieved. RESULTS Sixteen studies were eligible for inclusion. Sample sizes ranged from 15 to 157, with BMI 26-48 kg/m2. MF-BI underestimated fat mass (FM) in 11 studies and overestimated fat-free mass (FFM) in nine studies in comparison with reference methods. Correlations of absolute values from MF-BI and reference methods for FM and FFM were high, however, agreement was lower at an individual level. When adjustments for BMI were made to machine algorithms, measurement accuracy improved. Significant heterogeneity was evident among included studies. CONCLUSIONS This review found that MF-BI is reliable for use at a group level. Obese-specific adjustment of algorithms for MF-BI machines increases the accuracy of absolute measures of body composition in obese individuals, improving their utility in the clinical setting. Multiple variables contributed a lack of consistency among studies included, highlighting the need for more robust studies that control confounding variables to establish clear validity assessment.
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Affiliation(s)
- Louise Becroft
- Nutrition Department, The Alfred, Melbourne, Victoria, Australia. .,Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Victoria, Australia.
| | - Geraldine Ooi
- Monash University Department of Surgery, The Alfred, Melbourne, Victoria, Australia
| | - Adrienne Forsyth
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Victoria, Australia
| | - Susannah King
- Nutrition Department, The Alfred, Melbourne, Victoria, Australia.,Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Victoria, Australia
| | - Audrey Tierney
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Victoria, Australia.,School of Allied Health, University of Limerick, Limerick, Ireland
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SEGHETO KJ, SILVA DCGD, FERREIRA FG, CARVALHO MR, LONGO GZ. Excessive abdominal adiposity and body fat are associated with lower serum vitamin D levels: A population-based study. REV NUTR 2018. [DOI: 10.1590/1678-98652018000600002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
ABSTRACT Objective To estimate the prevalence of 25-hydroxyvitamin D deficiency and to analyze factors associated with lower serum vitamin levels in Brazilian adults. Methods A cross-sectional, population-based study consisted of 626 adult individuals of both sexes living in the urban area of Viçosa, Minas Gerais. The dependent variable used was the serum level of 25-hydroxyvitamin D and the independent variables were sociodemographic, anthropometric and body composition variables. The associations among the variables were verified using simple and multiple linear regression models, considering alpha lower than 0.05 for the input in the final model. Results The prevalence of 25-hydroxyvitamin D deficiency was 14.4% and the prevalence was 42.0%. Excess abdominal fat was higher in subjects with 25-hydroxyvitamin D sufficiency. The serum level of 25-hydroxyvitamin D was 30.34±9.85ng/ml. Body adiposity was higher in men with vitamin insufficiency. Negative associations were observed between serum 25-hydroxyvitamin D levels and age, educational level, body adiposity (p=0.028) and abdominal adiposity (p=0.023). Conclusion Our results showed that excess body and abdominal adiposity are strong predictors of alterations in the serum vitamin D levels, thus public policies for prevention and treatment in this population are essential.
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