-
Lyons Hardy heeft een update geplaatst 1 week, 3 dagen geleden
Protein-energy wasting is highly prevalent in people with end-stage kidney disease receiving regular hemodialysis. Currently, it is unclear what the optimal nutritional recommendations are, which is further complicated by differences in dietary patterns between countries. The aim of the study was to understand and compare dietary intake between individuals receiving hemodialysis in Leicester, UK and Nantong, China.
The study assessed 40 UK and 44 Chinese participants’ dietary intake over a period of 14days using 24-hour diet recall interviews. Nutritional blood parameters were obtained from medical records. Food consumed by participants in the UK and China was analyzed using the Nutritics and Nutrition calculator to quantify nutritional intake.
Energy and protein intake were comparable between UK and Chinese participants, but with both below the recommended daily intake. Potassium intake was higher in UK participants compared to Chinese participants (2,115 [888] versus 1,159 [861] mg/d; P<.001), as was calcium (618 [257] versus 360 [312] mg/d; P<.001) and phosphate intake (927 [485] versus 697 [434] mg/d; P=.007). Vitamin C intake was lower in UK participants compared to their Chinese counterparts (39 [51] versus 64 [42] mg/d; P=.024). Data are reported here as median (interquartile range).
Both UK and Chinese hemodialysis participants have insufficient protein and energy in their diet. New strategies are required to increase protein and energy intakes. All participants had inadequate daily intake of vitamins C and D; there may well be a role in the oral supplementation of these vitamins, and further studies are urgently needed.
Both UK and Chinese hemodialysis participants have insufficient protein and energy in their diet. New strategies are required to increase protein and energy intakes. All participants had inadequate daily intake of vitamins C and D; there may well be a role in the oral supplementation of these vitamins, and further studies are urgently needed.
Imbalance between anabolism and catabolism is linked to cachexia and protein-energy wasting (PEW), especially in frail populations such as patients with chronic kidney disease. Streptozocin PEW is responsible of poor outcomes with increased morbidity and mortality. Several causes are involved in PEW such as insulin resistance, acidosis, or hyperparathyroidism. Natriuretic peptides (NPs) have recently been described as activators of resting energy expenditure through the induction of browning of white adipose tissue in rodents with chronic kidney disease. The present study was therefore implemented to investigate whether NPs could be associated with PEW criteria and predict clinical outcomes.
We quantified serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) in a prospective cohort of 231 patients undergoing maintenance hemodialysis and atrial natriuretic peptide in a subgroup of 35 patients. Body composition parameters were measured with bioimpedance spectroscopy.
NT-proBNP was inversely associated with serumFurther studies are needed to confirm this association using resting energy expenditure measurement and adipose tissue biopsy.
Elderly people are considered to be in the risk group for vitamin D deficiency. The aim of the present study was to determine the effect of nursing interventions and sunlight exposure to reach optimum 25-hydroxyvitamin D [25(OH)D] levels by individuals living in nursing homes.
Randomized controlled experimental study was carried out in June-August 2018 period in the nursing home. The question form, standardized mini mental test, Fitzpatrick skin typing questionnaire and Katz Index of activities of daily living were applied. Individuals in the intervention group (n=20) was exposed to sunlight five days a week for four weeks in July with an average duration of 21 ± 5 minutes (min 15 – max 30 minutes). For the participants in the control group (n=20), sunbathing was not offered. 25(OH)D, calcium, parathormone, phosphorus, alkaline phosphatase and albumin levels of all individuals were measured at the beginning and end of the study.
At the end of the study, the 25(OH)D was significantly higher in the intervan independent nursing intervention is recommended for the elderly people living in nursing homes in order to prevent vitamin D deficiency and related consequences.BCOR-rearranged sarcoma is the third common subtype of undifferentiated small round cell sarcoma and was first recognized in 2012 from bone sarcoma with a similar morphological manifestation with undifferentiated round cell but totally different molecular hallmark from Ewing sarcoma. Primary BCOR-rearranged sarcomas were mostly found in bone and soft tissue and were sporadically reported in viscera involving kidney, which add difficulties in differential diagnosis. Here we present a 21 years old male patient with BCOR-CCNB3 in neck, which first diagnosed as thyroid cancer.
Although pediatric central venous catheterization is performed using ultrasound guidance, it is still a challenge. This study aimed to investigate the efficacy of the syringe-free, long-axis in-plane approach and compared the short-axis classic out-of-plane approach for ultrasound-guided central venous catheter placement in critically ill pediatric patients.
Prospective randomized study.
Single institution, tertiary university hospital, pediatric care unit.
The study comprised 60 patients ages three months to 15 years.
Participants were randomly divided into two equal groups. Group I (n = 30) incorporated patients who underwent the long-axis, syringe-free in-plane approach, and group II (n = 30) incorporated patients who underwent the short-axis out-of-plane approach.
Performing time, number of needle passes, number of skin punctures, first-pass success rate, and related complications were evaluated. There were no differences between the two groups in terms of demographics and vein-related measurements (p > 0.05). Performing time was statistically shorter in group I compared with group II (32 [25-38] v 58 [42-70] s; p < 0.001). There was no statistical difference between first-pass success rates between groups (group I 86.6% v group II 80%; p = 0.731). There were no significant differences between the groups in the number of needle passes and skin punctures (p = 0.219 and 0.508, respectively). Complications occurred in both groups, but there was no significant difference (4/30 v 7/30; p = 0.317).
The syringe-free, long-axis in-plane approach can be a safe and fast alternative for pediatric catheterization.
The syringe-free, long-axis in-plane approach can be a safe and fast alternative for pediatric catheterization.