The Dutch Childhood Cancer Survivor Study (DCCSS)-LATER 2 kidney analysis examined long-term glomerular dysfunction in childhood cancer survivors

This investigation aimed to evaluate glomerular dysfunction among childhood cancer survivors in comparison with matched controls from the general population. In the Dutch Childhood Cancer Survivor Study (DCCSS)-LATER 2 kidney analysis, a nationwide cross-sectional cohort study, 1024 survivors five or more years after diagnosis, aged 18 or more years at study, treated between 1963-2001 with nephrectomy, abdominal radiotherapy, total body irradiation, cisplatin, carboplatin, ifosfamide, high-dose cyclophosphamide or hematopoietic stem cell transplantation participated. In addition, 500 age- and sex-matched controls from Lifelines, a prospective population-based cohort study in the Netherlands, participated. At a median age of 32.0 years (interquartile range 26.6-37.4), the glomerular filtration rate was under 60 ml/min/1.73m2 in 3.7% of survivors and in none of the controls. Ten survivors had kidney failure. Chronic kidney disease according to age-thresholds (glomerular filtration rate respectively under 75 for age under 40, under 60 for ages 40-65, and under 40 for age over 65) was 6.6% in survivors vs. 0.2% in controls. Albuminuria (albumin-to-creatinine ratio over3 mg/mmol) was found in 16.2% of survivors and 1.2% of controls. Risk factors for chronic kidney disease, based on multivariable analyses, were nephrectomy (odds ratio 3.7 (95% Confidence interval 2.1-6.4)), abdominal radiotherapy (1.8 (1.1-2.9)), ifosfamide (2.9 (1.9-4.4)) and cisplatin over 500 mg/m2 (7.2 (3.4-15.2)). For albuminuria, risk factors were total body irradiation (2.3 (1.2-4.4)), abdominal radiotherapy over 30 Gy (2.6 (1.4- 5.0)) and ifosfamide (1.6 (1.0-2.4)). Hypertension and follow-up 30 or more years increased the risk for glomerular dysfunction. Thus, lifetime monitoring of glomerular function in survivors exposed to these identified high risk factors is warranted.</p

冠動脈バイパス手術後の急性腎不全に対する持続的血液透析療法開始時期に関する臨床的検討

　Acute renal failure requiring hemodialysis therapy after coronary artery bypass surgery occurs in 1 to 5% of patients, however, the optimal timing for initiation of hemodialysis therapy still remains undetermined. To assess when continuous hemodialysis therapy is begun, we studied the comparative survival between 14 patients who started to receive continuous hemodialysis therapy with the timing of decrease of urine volume less than 30 ml/hr and other 14 patients who waited to begin dialysis therapy until the level of urine volume of less than 20 ml/hr during 14 days. Between two groups, there were no significant differences in age, sex ratio, the score of APACHE (Acute Physiologic and Chronic Health Evaluation) II, and the levels of serum creatinine at the start of continuous hemodialysis therapy (2.9±0.2 vs 3.1±0.2 mg/dl) as well as the levels of serum creatinine at admission. Overall mortality of those patients was 50%. Twelve of fourteen patients who received continuous hemodialysis therapy with the timing of decrease of urine volume less than 30 ml/hour. In contrast, only 2 of 14 patients in the other group survived. There was a significant difference of p＜0.01 between two groups. The initiation of treatment for acute renal failure following after coronary artery bypass surgery would be determined by the decrease of urine volume but not the levels of serum creatinine. The early start of continuous hemodialysis therapy might be preferable for improvement of survival of the patients suffered from acute renal failure following coronary artery bypass surgery

身体活動を評価する簡易設問紙調査票の3軸加速度活動量計による妥当性

　身体活動を評価するために開発した、簡易身体活動調査票の妥当性を検討するため、20歳から59歳までの健康な男性30名を対象に、３軸加速度計を用いた７日間の身体活動調査と簡易身体活動調査票を用いた設問紙調査を実施した。７日間のデータから、１日あたりの平均歩数、平均メッツを算出した。簡易身体活動調査票から算出された点数を身体活動ポイントとし、１日あたりの平均歩数、平均メッツとの関連性をピアソンの相関係数を用いて評価した。身体活動ポイントと１日あたりの平均歩数（r＝0.59、p<0.01）、平均メッツ（r＝0.77、p<0.01）、共に両者の間に有意な正の相関関係が認められた。身体活動ポイントが高い人ほど、１日あたりの平均歩数、平均メッツは高く、我々の開発した簡易身体活動調査票は、対象者の身体活動を、高い妥当性で評価するツールとして有用である可能性が再確認された

Comparison of the ActiGraph acceloremeter and Bouchard diary to estimate energy expenditure in Spanish adolescents

Introduction: The aim of this study was to evaluate the agreement between the ActiGraph accelerometer and the Bouchard diary to estimate energy expenditure (EE) in a Spanish adolescent population. Methods: Sixty-one Spanish adolescents, aged 12-16 years, were recruited for this study. The Bouchard diary and the ActiGraph were administered for 3 consecutive days. EE estimated by the Bouchard diary was calculated using 2 different MET category values (BD-Bouchard and BD-Bratteby). EE estimated by the ActiGraph was calculated using 3 predictive equations (AC-Trost, AC-Freedson, and AC-Ekelund). Participants with complete 24 h data were also analyzed to control the possible loss of accuracy. Agreement was examined by Pearson and concordance correlations, paired t-test, and Bland-Altman method. Results: Thirty-seven adolescents were included in the analyses with complete 72 h. Relationships between EE calculated by the Bouchard diary and the ActiGraph were high (ranged: r = 0.61-0.78). Concordance correlations were moderate (rc = 0.60) by BD-Bratteby and AC-Trost, and low using BD-Bratteby and AC-Ekelund (rc = 0.15). EE estimated by BD-Bratteby and AC-Trost also showed no significant differences (P > 0.05) and absolutely agree 0.0 ± 5.0 MJ/d (95% confidence interval: ± 0.90 MJ/d), but with wide limits of agreement (± 9.80 MJ/d). Relationships were higher and differences were smaller in the 72 h sample than in the 24 h sample. Conclusions: The Bouchard diary and the ActiGraph showed high relationships, moderate concordance, and large differences to estimate EE in Spanish adolescents. Advantages, disadvantages, and agreements between both instruments must be taking into consideration for health-related research.Peer Reviewe

Ativo:A data inspired design used to manage energy expenditure for heart failure patients

\u3cp\u3eWe present three subsequent case studies to design for heart-failure patients at home. The process resulted in the design of Ativo—a tool to help heart-failure patients with their energy management. The research was done using a Jawbone Move activity tracker to obtain data from two heart-failure patients for three weeks each. During the three weeks period, a cultural probe was conducted twice in combination with patient interviews to collect information and data on their daily activities. Another probe was used to test the viability of the concepts. The data obtained captured the critical events that may have gone unnoticed, which helped us to make a design rationale. A conceptual prototype was created and validated with a heart-failure patient using the cognitive walkthrough method. We received positive responses showing that the patient liked to have alternative ways of tracking her energy level throughout the day. After a month, the patient reported continuous benefits from the awareness derived from using the prototype.\u3c/p\u3

Children with cerebral palsy do not achieve healthy physical activity levels

AimThis study compared daily activity energy expenditure (AEE) in children with cerebral palsy with a control group and investigated whether the children achieved healthy levels of physical activity. MethodsWe enrolled eight children with bilateral cerebral palsy, from eight to 10years of age, and a group of controls matched for age and gender. For three days, physical activity was simultaneously measured by accelerometers and self-reports using a diary. The daily AEE results were compared between groups and methods. The number of children that achieved healthy physical activity levels in each group was explored. ResultsChildren with cerebral palsy had significantly lower daily AEE, as measured by accelerometers, than the controls, and they did not achieve the healthy moderate to heavy physical activity level defined in the Nordic Nutrition Recommendations. Self-reports using the diaries resulted in an overestimation of physical activity compared with the ankle accelerometer measurements in both groups. ConclusionOur investigation of physical activity in children with cerebral palsy and controls using accelerometers and a diary found low levels of daily AEE and physical activity, and these results were most prominent in the group with cerebral palsy. The diaries overestimated physical activity in both groups.Funding Agencies|Norrbacka Eugenia Foundation; Royal Court Wedding Foundation</p