The effect of frequent hemodialysis on nutrition and body composition: frequent Hemodialysis Network Trial.

We investigated the effects of frequency of hemodialysis on nutritional status by analyzing the data in the Frequent Hemodialysis Network Trial. We compared changes in albumin, body weight, and composition among 245 patients randomized to six or three times per week in-center hemodialysis (Daily Trial) and 87 patients randomized to six times per week nocturnal or three times per week conventional hemodialysis, performed largely at home (Nocturnal Trial). In the Daily Trial, there were no significant differences between groups in changes in serum albumin or the equilibrated protein catabolic rate by 12 months. There was a significant relative decrease in predialysis body weight of 1.5 ± 0.2 kg in the six times per week group at 1 month, but this significantly rebounded by 1.3 ± 0.5 kg over the remaining 11 months. Extracellular water (ECW) decreased in the six times per week compared with the three per week hemodialysis group. There were no significant between-group differences in phase angle, intracellular water, or body cell mass (BCM). In the Nocturnal Trial, there were no significant between-group differences in any study parameter. Any gain in 'dry' body weight corresponded to increased adiposity rather than muscle mass but was not statistically significant. Thus, frequent in-center hemodialysis reduced ECW but did not increase serum albumin or BCM while frequent nocturnal hemodialysis yielded no net effect on parameters of nutritional status or body composition

Mean curvature flow with triple junctions in higher space dimensions

We consider mean curvature flow of n-dimensional surface clusters. At (n-1)-dimensional triple junctions an angle condition is required which in the symmetric case reduces to the well-known 120 degree angle condition. Using a novel parametrization of evolving surface clusters and a new existence and regularity approach for parabolic equations on surface clusters we show local well-posedness by a contraction argument in parabolic Hoelder spaces.Comment: 31 pages, 2 figure

Effect of frequent hemodialysis on residual kidney function.

Frequent hemodialysis can alter volume status, blood pressure, and the concentration of osmotically active solutes, each of which might affect residual kidney function (RKF). In the Frequent Hemodialysis Network Daily and Nocturnal Trials, we examined the effects of assignment to six compared with three-times-per-week hemodialysis on follow-up RKF. In both trials, baseline RKF was inversely correlated with number of years since onset of ESRD. In the Nocturnal Trial, 63 participants had non-zero RKF at baseline (mean urine volume 0.76 liter/day, urea clearance 2.3 ml/min, and creatinine clearance 4.7 ml/min). In those assigned to frequent nocturnal dialysis, these indices were all significantly lower at month 4 and were mostly so at month 12 compared with controls. In the frequent dialysis group, urine volume had declined to zero in 52% and 67% of patients at months 4 and 12, respectively, compared with 18% and 36% in controls. In the Daily Trial, 83 patients had non-zero RKF at baseline (mean urine volume 0.43 liter/day, urea clearance 1.2 ml/min, and creatinine clearance 2.7 ml/min). Here, treatment assignment did not significantly influence follow-up levels of the measured indices, although the range in baseline RKF was narrower, potentially limiting power to detect differences. Thus, frequent nocturnal hemodialysis appears to promote a more rapid loss of RKF, the mechanism of which remains to be determined. Whether RKF also declines with frequent daily treatment could not be determined

Real-time Atomistic Observation of Structural Phase Transformations in Individual Hafnia Nanorods

High-temperature phases of hafnium dioxide have exceptionally high dielectric constants and large bandgaps, but quenching them to room temperature remains a challenge. Scaling the bulk form to nanocrystals, while successful in stabilizing the tetragonal phase of isomorphous ZrO2, has produced nanorods with a twinned version of the room temperature monoclinic phase in HfO2. Here we use in situ heating in a scanning transmission electron microscope to observe the transformation of an HfO2 nanorod from monoclinic to tetragonal, with a transformation temperature suppressed by over 1000°C from bulk. When the nanorod is annealed, we observe with atomic-scale resolution the transformation from twinned-monoclinic to tetragonal, starting at a twin boundary and propagating via coherent transformation dislocation; the nanorod is reduced to hafnium on cooling. Unlike the bulk displacive transition, nanoscale size-confinement enables us to manipulate the transformation mechanism, and we observe discrete nucleation events and sigmoidal nucleation and growth kinetics

Early-life residential exposure to moisture damage is associated with persistent wheezing in a Finnish birth cohort

Background and Aims Moisture damage increases the risk for respiratory disorders in childhood. Our aim was to determine whether early age residential exposure to inspector-observed moisture damage or mold is associated with different wheezing phenotypes later in childhood. Methods Building inspections were performed by civil engineers, in a standardized manner, in the children's homes-mostly single family and row houses (N = 344)-in the first year of life. The children were followed up with repeated questionnaires until the age of 6 years and wheezing phenotypes-never/infrequent, transient, intermediate, late onset, and persistent-were defined using latent class analyses. The multinomial logistic regression model was used for statistical analysis. Results A total of 63% (n = 218) had infrequent or no wheeze, 23% (n = 80) had transient and 9.6% (n = 21) had a persistent wheeze. Due to the low prevalence, results for intermediate (3.8%, n = 13) and late-onset wheeze (3.5%, n = 12) were not further evaluated. Most consistent associations were observed with the persistent wheeze phenotype with an adjusted odds ratio (95% confidence intervals) 2.04 (0.67-6.18) for minor moisture damage with or without mold spots (present in 23.8% of homes) and 3.68 (1.04-13.05) for major damage or any moisture damage with visible mold in a child's main living areas (present in 13.4% of homes). Early-age moisture damage or mold in the kitchen was associated with transient wheezing. Conclusion At an early age, residential exposure to moisture damage or mold, can be dose-dependently associated especially with persistent wheezing phenotype later in childhood.Peer reviewe

CX3CR1 Polymorphisms are associated with atopy but not asthma in German children

Chemokines and their receptors are involved in many aspects of immunity. Chemokine CX3CL1, acting via its receptor CX3CR1, regulates monocyte migration and macrophage differentiation as well as T cell-dependent inflammation. Two common, nonsynonymous polymorphisms in CX3CR1 have previously been shown to alter the function of the CX3CL1/CX3CR1 pathway and were suggested to modify the risk for asthma. Using matrix-assisted laser desorption/ionization time-of-flight technology, we genotyped polymorphisms Val249Ile and Thr280Met in a cross-sectional population of German children from Munich (n = 1,159) and Dresden ( n = 1,940). For 249Ile an odds ratio of 0.77 (95% confidence interval 0.63-0.96; p = 0.017) and for 280Met an odds ratio of 0.71 ( 95% confidence interval 0.56-0.89; p = 0.004) were found with atopy in Dresden but not in Munich. Neither polymorphism was associated with asthma. Thus, amino acid changes in CX3CR1 may influence the development of atopy but not asthma in German children. Potentially, other factors such as environmental effects may modify the role of CX3CR1 polymorphisms. Copyright (c) 2007 S. Karger AG, Basel

Asthma Phenotypes in Childhood

INTRODUCTION: Asthma is no longer thought of as a single disease, but rather a collection of varying symptoms expressing different disease patterns. One of the ongoing challenges is understanding the underlying pathophysiological mechanisms that may be responsible for the varying responses to treatment. Areas Covered: This review provides an overview of our current understanding of the asthma phenotype concept in childhood and describes key findings from both conventional and data-driven methods. Expert Commentary: With the vast amounts of data generated from cohorts, there is hope that we can elucidate distinct pathophysiological mechanisms, or endotypes. In return, this would lead to better patient stratification and disease management, thereby providing true personalised medicine

DESEMPENHO DE CORDEIROS NATURALMENTE INFECTADOS COM PARASITAS GASTRINTESTINAIS UTILIZANDO O TRATAMENTO SELETIVO COM O MÉTODO FAMACHA E O TRATAMENTO PREVENTIVO

The objective of the present workwas to evaluate the weight gain in lambs using twosystems of parasite control in between 14/11/04 and14/03/05. Thirty four animals of the Ile de Francebreed where used in two groups of 17 animals(G1 and G2). The G1 group was evaluated at14-days interval using Famacha, diarrhea and bodycondition score and fecal exam (EPG) at the samefrequency being treated with moxidectin in casethey manifested any clinical sign. The G2 group wastreated with the same compound at 30-days interval.The correlation of Famacha 2, 3 and 4 and thevariables EPG and weight was of 0,903 and 0,662,respectively. The groups demonstrated no differenceon their final weight gain (P=0,110). There was thepredominance of the Haemonchus contortus speciesfor G1 (62,94%) and G2 (64,14%). The option totreat animals using the selective system reduced by87,5% the treatment cost when compared with thepreventive regime. The target selective treatmentusing the Famacha method allows a very efficientparasite control when there is a high prevalence ofthe parasite H. contortus. The data permit inferringabout the possibility to select less tolerant animalsduring a period of heavier parasite challenge.O objetivo do presente trabalho foiavaliar o ganho de peso em cordeiros utilizandoduas práticas de controle parasitário entre 14/11/04a 14/03/05. Trinta e quatro animais da raça Ile deFrance compuseram dois grupos de 17 animais (G1e G2). O grupo G1 foi avaliado em intervalos de 14dias utilizado o método Famacha, o escore de diarréia,exame de fezes (OPG) e o escore de condiçãocorporal na mesma freqüência, sendo tratados commoxidectina caso apresentassem comprometimentoclínico. O grupo G2 foi tratado com o mesmo princípioativo em intervalos de 30 dias. A correlação devalores Famacha entre 2, 3 e 4 e as variáveis OPGe peso foi de 0,903 e 0,662, respectivamente. Osgrupos não apresentaram diferença no ganho depeso total (P=0,110). Houve predominância da espécieHaemonchus contortus para G1 (62,94%) eG2 (64,14%). A opção de tratar os animais com osistema seletivo reduziu em 87,5% o custo do tratamento,quando comparado com o regime preventivo.O tratamento seletivo com o método Famachapermite um controle parasitário eficiente quandoexiste alta prevalência do parasita H. contortus. Estesdados permitem inferir sobre a possibilidade deseleção de animais menos tolerantes durante umperíodo de maior desafio parasitário