Oral Sodium Bicarbonate Supplementation Does Not Affect Serum Calcification Propensity in Patients with Chronic Kidney Disease and Chronic Metabolic Acidosis

Background: Cardiovascular disease is the leading cause of death in patients with chronic kidney disease (CKD) and metabolic acidosis might accelerate vascular calcification. The T50 calcification inhibition test (T50-test) is a global functional test analyzing the overall propensity of calcification in serum, and low T50-time is associated with progressive aortic stiffening and with all-cause mortality in non-dialysis CKD, dialysis, and transplant patients. Low serum bicarbonate is associated with a short T50-time and alkali supplementation could be a simple modifier of calcification propensity. The aim of this study was to investigate the short-term effect of oral sodium bicarbonate supplementation on T50-time in CKD patients. Material and Methods: The SoBic-study is an ongoing randomized-controlled trial in CKD-G3 and G4 patients with chronic metabolic acidosis (serum HCO3– ≤21 mmol/L), in which patients are randomized to either achieve serum HCO3– levels of 24 ± 1 mmol/L (intervention group) or 20 ± 1 mmol/L (rescue group). The effect of bicarbonate treatment on T50-time was assessed. Results: The study cohort consisted of 35 (14 female) patients aged 57 (±15) years, and 18 were randomized to the intervention group. The mean T50-time was 275 (± 64) min. After 4 weeks, the mean change of T50-time was 4 (±69) min in the intervention group and 18 min (±56) in the rescue group (β = –25; 95% CI: –71 to 22; p = 0.298). Moreover, change of serum bicarbonate in individual patients was not associated with change in T50-time, analyzed by regression analysis. Change of serum phosphate had a significant impact on change of T50-time (β = –145; 95% CI: –237 to –52). Conclusion: Oral sodium bicarbonate supplementation showed no effect on T50-time in acidotic CKD patients

Hemodynamic effects of intraoperative 30% versus 80% oxygen concentrations: an exploratory analysis

BackgroundSupplemental oxygen leads to an increase in peripheral vascular resistance which finally increases systemic blood pressure in healthy subjects and patients with coronary artery disease, heart failure, undergoing heart surgery, and with sepsis. However, it is unknown whether this effect can also be observed in anesthetized patients having surgery. Thus, we evaluated in this exploratory analysis of a randomized controlled trial the effect of 80% versus 30% oxygen on intraoperative blood pressure and heart rate.MethodsWe present data from a previous study including 258 patients, who were randomized to a perioperative inspiratory FiO2 of 0.8 (128 patients) versus 0.3 (130 patients) for major abdominal surgery. Continuous arterial blood pressure values were recorded every three seconds and were exported from the electronic anesthesia record system. We calculated time-weighted average (TWA) and Average Real Variability (ARV) of mean arterial blood pressure and of heart rate.ResultsThere was no significant difference in TWA of mean arterial pressure between the 80% (80 mmHg [76, 85]) and 30% (81 mmHg [77, 86]) oxygen group (effect estimate −0.16 mmHg, CI –1.83 to 1.51; p = 0.85). There was also no significant difference in TWA of heart rate between the 80 and 30% oxygen group (median TWA of heart rate in the 80% oxygen group: 65 beats.min−1 [58, 72], and in the 30% oxygen group: 64 beats.min−1 [58; 70]; effect estimate: 0.12 beats.min−1, CI –2.55 to 2.8, p = 0.94). Also for ARV values, no significant differences between groups could be detected.ConclusionIn contrast to previous results, we did not observe a significant increase in blood pressure or a significant decrease in heart rate in patients, who received 80% oxygen as compared to patients, who received 30% oxygen during surgery and for the first two postoperative hours. Thus, hemodynamic effects of supplemental oxygen might play a negligible role in anesthetized patients.Clinical Trail Registrationhttps://clinicaltrials.gov/ct2/show/NCT03366857?term=vienna&cond=oxygen&draw=2&rank=

Biomechanical punch-analysis in Kyokushin-Karate

Abweichender Titel laut Übersetzung der Verfasserin/des VerfassersZsfassung in engl. SpracheLaut diversen Reportagen [vgl.: Stern, 2006] und Publikationen [vgl.: Pierce, 2006] [vgl.: Walilko, 2005] hat ein Kampfsportler eine Schlagkraft die von 500N bis 7000N reicht. Diese Kraft kann Blutgefäße zum Platzen, Gefäße zum Verengen und Organe zum Verkrampfen bringen.Normalerweise führt sie zu einem KO oder schwerwiegenden Verletzungen.In dieser Arbeit wird speziell auf die verschiedenen Verletzungsmöglichkeiten eingegangen, die durch eine Kraftübertragung in diesem Ausmaß entstehen können. Im Kampf kommt es selten zu der Möglichkeit einen Schlag dieser Wucht am Gegner anzubringen. Durch Ausweich und Blockmanöver wird ein Großteil der Schlagkraft abgelenkt, die restliche Kraft wird durch Fett- und Muskelgewebe aufgenommen. Durch langjähriges Training werden die Muskeln auf die harten Schläge vorbereitet und angepasst. Kyokushin-Karate ist, vom Shotokan-Karate abstammend, eine der härtesten traditionellen Kampfsportarten. Leistungsorientierte Kämpfer des Kyokushin-Karate Stils trainieren Jahre lang ihre Muskeln, um eine größere Widerstandsfähigkeit gegen Schläge aufzubringen, da mit vollem Kontakt und beim Turnier bis zum KO gekämpft wird. In dieser Arbeit dienen erfahrene Kyokushin-Karateka als Probanden für die Messung von physikalischen Wirkungskomponenten, die den Grad der Schlagwirkung bestimmen. Ziel dieser Untersuchung ist es, mit Hilfe moderner Sensortechnik, welche im Zuge der Diplomarbeit "Sensortechnik für Schlagmessungen im Kampfsport" [vgl.: Fraunschiel, 2008] entwickelt wurde, die Beschleunigung und die Kraft der Schläge zu messen. Schläge, die auf einem Boxsack ausgeführt werden, werden mit jenen verglichen, die auf ein im Boden verankertes Holzbrett (Makiwara) durchgeführt werden. Der Boxsack repräsentiert einen mit Fettgewebe behafteten Oberkörper, das Makiwara einen muskulösen Körper. Als Unterstützung für die Bewegungsanalyse dienen drei High-Speed Kameras, die die Bewegungen filmen und anhand der Daten nachfolgend verschiedene Berechnungen durchgeführt werden können. Diese Informationen werden herangezogen um die Effizienz der einzelnen Techniken untereinander zu vergleichen und bestehenden Messwerten gegenüber zu stellen.According to different reports [cf.: Stern, 2006] and papers [cf.: Pierce, 2006] [cf.: Walilko, 2005], a martial artist is able to punch with up to 7000N. This value describes a force, which is able to burst or constrict blood vessels and lets organs clench. Usually this force leads to a KO or a severe injury. This work presents different injury-possibilities. Usually the forces which are assigned to the opponent are smaller, because of evasion-maneuvers, which lead most of the punch-force away. The rest of the force doesn't matter because of the fighters' hard trained bodies. Kyokushin-Karate descends of Shotokan-Karate, the grandfather of Karate-stiles. It is a full contact sport in which the participants of a tournament try to knock the opponent out. In this work Kyokushin-Karateka are the test persons for the measurement of values which describe the physical effect. The aim of this work is to find out how hard they hit and how high the acceleration is, using sensor modules, which were developed in the course of the diploma thesis "Sensortechnik für Schlagmessungen im Kampfsport". [cf.:Fraunschiel, 2008] The outcomes are compared with values of the research. Finally, punches onto a soft object are compared with punches to hard objects. These objects represent a corpulent and a thin opponent. For assistance, a motion-analysis with three high-speed cameras was accomplished. On the basis of these data, the motion-analysis software consequently makes several useful calculations.These data are the basis for the comparison of the techniques' efficiency.10

Sensortechnology for punch-measurements in martial arts

Abweichender Titel laut Übersetzung der Verfasserin/des VerfassersDie Leistungsdiagnostik hat in der Kampfsportart Kyokushin-Karate bisher kaum Beachtung gefunden. Die trainingswissenschaftlichen Untersuchungen, die im europäischen Raum durchgeführt werden, beschränken sich vor allem auf Breitensportarten.Im Bereich der biomechanischen Technikanalyse im Kampfsport existieren einige Publikationen über Boxsport und Semi-Kontakt Karate. Keiner der Verfasser geht jedoch näher auf den Vollkontakt-Kampfsport Kyokushin-Karate ein, obwohl gerade in diesem traditionellen Kampfsport die Stärke und Präzision der Schläge zu einem KO des Gegners führen.Ziel dieser Arbeit ist es eine Instrumentierung für die Kraft- und Beschleunigungsmessung von Faustschlägen bzw. Beintechniken zu entwickeln. Sie soll den Kämpfern eine Rückmeldung über die Wirkung ihrer Schläge liefern, wodurch diese ihre Schlagtechniken perfektionieren können. Im Zuge dieser Arbeit werden fünf Sensoren analysiert, und falls sie sich als wertvoll erweisen, hergestellt und kalibriert. Drei von fünf Sensoren mussten im Laufe der Arbeit verworfen werden, da sie nicht den geforderten Ansprüchen gerecht wurden.The performance-diagnostic in the full-contact martial art Kyokushin-Karate hasn't attracted attention so far. In the range of the scientific technique-analysis in martial arts exist some publications about boxing and semi-contact Karate. No one of the authors goes into the full-contact martial art, Kyokushin-Karate, even though the force of punches leads to a KO in this traditional martial art. The aim of this diploma thesis is to create an instrumentation to bring the martial artists' techniques to perfection. Due to responses of an advice, which shows the fighters how energetic their punches are, punch and kick techniques can be sophisticated. In the course of this work five sensors are analyzed and furthermore, if they have turned out to be valuable, built and calibrated. Three of five sensors have unfortunately been condemned because of uselessness.8

Perioperative Supplemental Oxygen and Plasma Catecholamine Concentrations after Major Abdominal Surgery—Secondary Analysis of a Randomized Clinical Trial

Perioperative stress is associated with increased sympathetic activity that leads to increases in heart rate and blood pressure, which are associated with the development of perioperative myocardial ischemia. In healthy volunteers, it was shown that the administration of supplemental oxygen attenuated sympathetic nerve activity and subsequently led to lower plasma catecholamine concentrations. We therefore tested the hypothesis that perioperative supplemental oxygen attenuates sympathetic nerve in patients at risk for cardiovascular complications undergoing major abdominal surgery. We randomly assigned 81 patients to receive either 80% or 30% inspired oxygen concentration throughout surgery and the first two postoperative hours. We assessed noradrenaline, adrenaline, and dopamine plasma concentrations before the induction of anesthesia, two hours after surgery and on the third postoperative day. There was no significant difference in postoperative noradrenaline (effect estimated: −41.5 ng·L−1, 95%CI −134.3, 51.2; p = 0.38), adrenaline (effect estimated: 11.2 ng·L−1, 95%CI −7.6, 30.1; p = 0.24), and dopamine (effect estimated: −1.61 ng·L−1, 95%CI −7.2, 3.9; p = 0.57) concentrations between both groups. Based on our results, it seems unlikely that supplemental oxygen influences endogenous catecholamine release in the perioperative setting

Data_Sheet_1_Supplemental oxygen did not significantly affect two-year mortality in patients at-risk for cardiovascular complications undergoing moderate- to high-risk abdominal surgery–A follow-up analysis of a prospective randomized clinical trial.docx

BackgroundIn relatively healthy middle-aged patients, recent studies have shown that supplemental oxygen did not significantly increase one-year mortality after noncardiac surgery. If supplemental oxygen influences long-term mortality, specifically in elderly patients with cardiovascular risk-factors, remains unknown. Thus, we evaluated the effect of supplemental oxygen on two-year mortality in patients with cardiovascular risk factors undergoing moderate- to high-risk major abdominal surgery.MethodsThis is a follow-up study of a prospective, randomized, double-blinded, clinical trial. Two hundred fifty-eight patients, who were at least 45 years of age and at-risk for cardiovascular complications were randomly assigned to receive 80 vs. 30% oxygen during surgery and for the first two postoperative hours. Vital status was obtained from all patients 2 years after surgery using the national registry. Preoperative and postoperative maximum concentrations of NT-proBNP, Troponin T (TnT), Copeptin, von Willebrand Factor (vWF), static oxidation-reduction potential (sORP) and oxidation-reduction potential capacity (cORP) were tested for association with two-year mortality.ResultsThe median age of patients was 74 years (25th-75th percentile 70–78 years). 25.8% (95% CI: 17.3–32.4%) of patients in the 80% oxygen group and 22.3% (95% CI: 14.8–29.1%) in the 30% oxygen group died within 2 years after surgery. No significant difference in two-year mortality was found between patients, who received 80% oxygen concentration, versus patients, who received 30% oxygen concentration (estimated hazard ratio 1.145; 95% CI 0.693–1.893; p = 0.597). Preoperative Copeptin concentrations and postoperative maximum vWF activity were significantly associated with two-year mortality (p ConclusionOur results are consistent with previous studies, that showed that supplemental oxygen did not increase long-term mortality. Therefore, it is becoming more evident that supplemental oxygen may not have a significant effect on long-term outcome in patients undergoing major abdominal surgery.</p