The association of hydration status with physical signs, symptoms and survival in advanced cancer-The use of Bioelectrical Impedance Vector Analysis (BIVA) technology to evaluate fluid volume in palliative care: An observational study

Background Hydration in advanced cancer is a controversial area; however, current hydration assessments methods are poorly developed. Bioelectrical impedance vector analysis (BIVA) is an accurate hydration tool; however its application in advanced cancer has not been explored. This study used BIVA to evaluate hydration status in advanced cancer to examine the association of fluid status with symptoms, physical signs, renal biochemical measures and survival. Materials and methods An observational study of 90 adults with advanced cancer receiving care in a UK specialist palliative care inpatient unit was conducted. Hydration status was assessed using BIVA in addition to assessments of symptoms, physical signs, performance status, renal biochemical measures, oral fluid intake and medications. The association of clinical variables with hydration was evaluated using regression analysis. A survival analysis was conducted to examine the influence of hydration status and renal failure. Results The hydration status of participants was normal in 43 (47.8%), 'more hydrated' in 37 (41.1%) and 'less hydrated' in 10 (11.1%). Lower hydration was associated with increased symptom intensity (Beta = -0.29, p = 0.04) and higher scores for physical signs associated with dehydration (Beta = 10.94, p = 0.02). Higher hydration was associated with oedema (Beta = 2.55, p<0.001). Median survival was statistically significantly shorter in 'less hydrated' patients (44 vs. 68 days; p = 0.049) and in pre-renal failure (44 vs. 100 days; p = 0.003). Conclusions In advanced cancer, hydration status was associated with clinical signs and symptoms. Hydration status and pre-renal failure were independent predictors of survival. Further studies can establish the utility of BIVA as a standardised hydration assessment tool and explore its potential research application, in order to inform the clinical management of fluid balance in patients with advanced cancer

EFEITO DO ALUMÃNIO NOS TEORES DE CLOROFILAS DE PLÃNTULAS DE FEIJÃO-MUNGO E LABE-LABE

No presente trabalho verificou-se o efeito do alumínio nos teores de clorofilas de plântulas das leguminosas feijão-mungo (Vigna radiata (L.) Wilczek, cv. KY 2184) e do labe-labe (Lablab purpureus (L.) Sweet, cv. Rongai), cultivadas em solução nutritiva. Inicialmente, as sementes foram semeadas em vermiculita expandida, e após 10 dias as plântulas mais vigorosas foram transferidas para frascos de vidro de 190 mL, contendo solução nutritiva de Clark e concentrações de alumínio (0,0; 0,25; 0,5 e 1,0 mmol dm-3). O delineamento experimental foi o inteiramente casualizado com arranjo fatorial 2x4 e três repetições. O experimento foi conduzido por 20 dias em sala de crescimento com fotoperíodo de 12/12 horas, com irradiância média de 42,86 &#61549;mol m-2 s-1 e temperatura ambiente (mínima média de 24&#61616;C &#61617; 1&#61616;C e máxima mínima de 27&#61616;C &#61617; 1&#61616;C). Determinaram-se os teores de clorofilas através de leituras espectrofotométricas nas absorbâncias A645, A652 e A663 nm. A Análise dos resultados mostrou que, não houve efeito do alumínio nos teores de clorofilas, indicando que estas espécies nestas condições experimentais parecem ser tolerantes ao alumínio, podendo ser cultivadas em solos ácidos que apresentem disponibilidade deste elemento mineral. Palavras-chave: Pigmentos, leguminosas, sulfato de alumínio, solução nutritiva. ABSTRACT This work focused on the effects of aluminum (Al) on conten of chlorophyll of mungbean (Vigna radiata (L.) Wilczek, cv. KY 2184) and lablab (Lablab purpureus (L.) Sweet, cv. Rongai) seedlings. The seed were germinated in trays filled with vermiculite, for 10 days. Plants were grown in Clark's nutrient solution adjusted each three days to pH 3.8 and containing four Al concentrations ( 0.0, 0.25, 0.5 and 1.0 mmol dm-3). The experimental design was a complete randomized in factorial arragement 2x4 and three replications. The experiment was conducted for 20 days at ambient room (12/12 hours photoperiod with 42,86 &#61549;mol m-2 s-1 and 27&#61616;C &#61617; 1&#61616;C maximum and 24&#61616;C &#61617; 1&#61616;C minimum temperature). At the end of the experiment (20 days after transplanting) the chlorophyll content was determined by spectrophotometric absorbancy readings at A645, A652 e A663 nm. The results showed that the aluminum concentrations used did not cause effects on conten of chlorophyll of mungbean and lablab seedlings, indicated that plants can be cultived in acid soils with aluminum availability. Under the the experimental conditions of this research, both species seems to be tolerant to aluminum stress. Key words: Pigments, legumes, nutrient solution, aluminum sulphat

Effect of a dialysis session on the prognostic values of NT-proBNP, troponins, endothelial damage and inflammation biomarkers

Abstract BACKGROUND: In hemodialysis, the relationship between the increased concentration of natriuretic peptides and volume overload, inflammatory activity, endothelial dysfunction, left ventricular function and mass, and silent ischemic events is not clear. To investigate the relationship, a 3-year prospective cohort study was conducted in 50 adult hemodialysis patients in NYHA class I-II who were free from diabetes and ischemic heart events. METHODS: Doppler echocardiogram, plasma NT-proBNP, troponin T and I, CRP, TNF alpha, big-endothelin 1, and cystatin-C, were determined both before and after a dialysis session. The outcome was all-cause death. RESULTS: 13 out of 50 patients died. Survival curves significantly differed by age (above vs. below the median 68 yrs), NT-proBNP (9719 pg/mL), troponin T (0.03 ng/mL), C-reactive protein (4.8 mg/L), left atrial volume index (51 mL/sqm), ejection fraction (61%), and diastolic pattern. In the Cox model only NT-proBNP (cutoff 10000 pg/mL) had a significant hazard ratio (4.1). Post-HD measurements of NT-proBNP, troponin T, and CRP maintained their prognostic value. The high correlation between pre and post values of NT-proBNP, and the lack of correlation with ultrafiltration volume excluded a role for acute fluid removal on its regulation. CONCLUSIONS: The increased level of NT-proBNP is the most important prognostic factor even in the absence of severe heart dysfunction and myocardial ischemic events, without any relationship with endothelial dysfunction, inflammatory biomarkers, or with acute fluid removal. A cutoff value of NT-proBNP of 10000 pg/mL could be used to identify hemodialysis patients with a higher risk of death

Renal dysfunction is a confounder for plasma natriuretic peptides in detectingheart dysfunction in uremic and idiopathic dilated cardiomyopathies.

Clin Chem. 2007 Dec;53(12):2097-104. Epub 2007 Oct 12. Renal dysfunction is a confounder for plasma natriuretic peptides in detecting heart dysfunction in uremic and idiopathic dilated cardiomyopathies. Codognotto M, Piccoli A, Zaninotto M, Mion M, Plebani M, Vertolli U, Tona F, Ruzza L, Barchita A, Boffa GM. Source Division of Nephrology, University Hospital, University of Padova, Italy. Abstract BACKGROUND: The diagnostic value of natriuretic peptides in uremic cardiomyopathy has not been defined, nor has the effect of a hemodialysis (HD) session on peptides. METHODS: We performed an observational study of 100 white adult outpatients in New York Heart Association class I-II, with neither diabetes nor ischemic heart disease, 50 of whom had idiopathic dilated cardiomyopathy (DCM) and 50 of whom had uremic cardiomyopathy and were undergoing HD. We measured plasma N-terminal proB-type natriuretic peptide (NT-proBNP), BNP, and atrial natriuretic peptide (ANP) both before and after a dialysis session. Doppler echocardiograms were evaluated. We performed multiple regression analysis on the logarithm of peptide concentrations using clinical, laboratory, and echocardio-Doppler data as explanatory variables. RESULTS: Mean peptide concentrations were higher in the HD group, with an HD:DCM ratio of 25 for NT-proBNP and 5 for BNP and ANP. Peptides were correlated with each other (r > 0.85). After HD, NT-proBNP significantly increased by 14%, BNP decreased by 17%, and ANP decreased by 56%. Predialysis concentrations correlated with postdialysis values (r > 0.85). A multiple regression equation significantly fitted the observed peptide concentrations, both pre- and postdialysis, using the same set of 4 variables: disease group (DCM or HD), diastolic pattern, left atrial volume, and body mass index. CONCLUSIONS: Renal dysfunction was a confounder for natriuretic peptides, which were present in higher concentrations in the uremic patients with milder cardiac dysfunction than in those with idiopathic DCM without renal dysfunction. Left diastolic function pattern and atrial volume were cardiac determinants of peptide concentrations in DCM and HD

Detecting cocaine use? The autobiographical implicit association test (aIAT) produces false positives in a real-world setting.

The aIAT is a variant of an attitude measure and can be better rationalized if propositional thinking is implied to explain outcomes. The Relational Frame and Social Knowledge Structure theories can perhaps provide a more plausible theoretical background. Further work is required to clarify which factors underlie this testing technique's functioning. Reappraisal is advised before further forensic use of the instrument to ensure that general associations not related to autobiographical memory do not confound results