20 research outputs found
Utility of Phase Angle to Identify Cachexia and Assess Mortality in End-Stage Renal Disease
© 2020 American Society for Nutrition. Published by Elsevier Inc. This is an Open access article under the CC-BY-NC-ND license. https://creativecommons.org/licenses/by-nc-nd/4.0/Objectives This cross-sectional analysis sought to identify cachexia and assess survival using phase angle (PA) in patients with end-stage renal disease (ESRD) receiving haemodialysis. Methods Patients receiving haemodialysis (n = 87, mean age 65.9 +/â 13.0) completed a Phase Angle (PA; 50 khz) measurement using bioelectrical impedance analysis. Cachexia variables were recorded according to Evans et al. definition (2008) including nutritional and functional measures (weight, Body Mass Index (BMI), Hand Grip Strength (HGS), Lean Tissue Mass (LTM), C-Reative Protein (CRP), serum albumin, haemoglobin, appetite (Functional Assessment of Anorexia/Cachexia Treatment (FAACT)) and fatigue (Functional Assessment of Chronic Illness Therapy (FACIT)). Survival was assessed at 12 months. Mann Whitney-U and Spearman correlation coefficient were conducted. Results The majority of patients completed follow up (n = 76). Eleven patients had died. Mean PA was not statistically different between those identified as cachectic and non-cachectic according to Evans et al. (2008) definition or between those patients that survived and died. However, patients that survived had better mean scores of weight, BMI, HGS, CRP, serum albumin and fatigue (FACIT). In addition, LTM scores were significantly better in patients that survived (P < .01). Appetite scores were also significantly better in patients that survived (P < .01) and those without cachexia (P = .01). Conclusions This study was part of a larger effort to clarity a phenotype of cachexia in ESRD. Unlike previous research, this study did not find PA useful in identifying patients at a higher risk of cachexia or death. However overall these patients had a very low mean PA. FAACT did discriminate between groups indicating self-reporting measurement tools of nutritional status were useful in identifying patients at a higher risk of cachexia and death. A larger sample and longer follow up is required to balance the limitations of this small study. Timing the administration of PA also requires consideration in future studies. Funding Sources Public Health Agency; Northern Ireland Kidney Research Fund.Peer reviewe
Com o diabo no corpo: os terrĂveis papagaios do Brasil colĂŽnia
Desde a Antiguidade, papagaios, periquitos e afins (Psittacidae) fascinaram os europeus por seu vivo colorido e uma notĂĄvel capacidade de interação com seres humanos. A descoberta do Novo Mundo nada faria alĂ©m de acrescentar novos elementos ao trĂĄfico de animais exĂłticos hĂĄ muito estabelecido pelos europeus com a Ăfrica e o Oriente. Sem possuir grandes mamĂferos, a AmĂ©rica tropical participaria desse comĂ©rcio com o que tinha de mais atrativo, essencialmente felinos, primatas e aves - em particular os papagaios, os quais eram embarcados em bom nĂșmero. Contudo, a julgar pelos documentos do Brasil colĂŽnia, esses volĂĄteis podiam inspirar muito pouca simpatia, pois nenhum outro animal - exceto as formigas - foi tantas vezes mencionado como praga para a agricultura. AlĂ©m disso, alguns psitĂĄcidas mostravam-se tĂŁo loquazes que inspiravam a sĂ©ria desconfiança de serem animais demonĂacos ou possessos, pois sĂł trĂȘs classes de entidades - anjos, homens e demĂŽnios - possuĂam o dom da palavra. Nos dias de hoje, vĂĄrios representantes dos Psittacidae ainda constituem uma ameaça para a agricultura, enquanto os indivĂduos muito faladores continuam despertando a suspeita de estarem possuĂdos pelo demĂŽnio. Transcendendo a mera curiosidade, essa crença exemplifica o quĂŁo intrincadas podem ser as relaçÔes do homem com o chamado âmundo naturalâ, revelando um universo mais amplo e multifacetado do que se poderia supor a princĂpio. Nesse sentido, a existĂȘncia de aves capazes de falar torna essa relação ainda mais complexa e evidencia que as dificuldades de estabelecer o limite entre o animal e o humano se estendem alĂ©m dos primatas e envolvem as mais inusitadas espĂ©cies zoolĂłgicas.Since ancient times, parrots and their allies (Psittacidae) have fascinated Europeans by their striking colors and notable ability to interact with human beings. The discovery of the New World added new species to the international exotic animal trade, which for many centuries had brought beasts to Europe from Africa and the Orient. Lacking large mammals, tropical America participated in this trade with its most appealing species, essentially felines, primates and birds - especially parrots - which were shipped in large numbers. It should be noted, however, that at times these birds were not well liked. In fact, according to documents from colonial Brazil, only the ants rank higher than parrots as the animals most often mentioned as agricultural pests. On the other hand, some of these birds were so chatty that people suspected them to be demonic or possessed animals, since only three classes of beings - angels, men and demons - have the ability to speak. Nowadays, several Psittacidae still constitute a threat to agriculture, and the suspicion that extremely talkative birds were demon possessed has also survived. More than a joke or a mere curiosity, this belief exemplifies how intricate manâs relationships with the ânatural worldâ may be. In this sense, the existence of birds that are able to speak adds a further twist to these relationships, demonstrating that the problem of establishing a boundary between the animal and the human does not only involve primates, but also includes some unusual zoological species
Anatomical integration and rich-club connectivity in euthymic bipolar disorder
Background. Although repeatedly associated with white matter microstructural alterations, bipolar disorder (BD) has
been relatively unexplored using complex network analysis. This method combines structural and diffusion magnetic
resonance imaging (MRI) to model the brain as a network and evaluate its topological properties. A group of highly
interconnected high-density structures, termed the ârich-clubâ, represents an important network for integration of
brain functioning. This study aimed to assess structural and rich-club connectivity properties in BD through graph theory
analyses.
Method. We obtained structural and diffusion MRI scans from 42 euthymic patients with BD type I and 43 age- and
gender-matched healthy volunteers. Weighted fractional anisotropy connections mapped between cortical and subcortical
structures defined the neuroanatomical networks. Next, we examined between-group differences in features of
graph properties and sub-networks.
Results. Patients exhibited significantly reduced clustering coefficient and global efficiency, compared with controls globally
and regionally in frontal and occipital regions. Additionally, patients displayed weaker sub-network connectivity in
distributed regions. Rich-club analysis revealed subtly reduced density in patients, which did not withstand multiple
comparison correction. However, hub identification in most participants indicated differentially affected rich-club membership
in the BD group, with two hubs absent when compared with controls, namely the superior frontal gyrus and
thalamus.
Conclusions. This graph theory analysis presents a thorough investigation of topological features of connectivity in
euthymic BD. Abnormalities of global and local measures and network components provide further neuroanatomically
specific evidence for distributed dysconnectivity as a trait feature of BD.status: publishe
Neuroanatomical dysconnectivity underlying cognitive deficits in bipolar disorder
BACKGROUND: Graph theory applied to brain networks is an emerging approach to understanding the brain\u27s topological associations with human cognitive ability. Despite well-documented cognitive impairments in bipolar disorder (BD) and recent reports of altered anatomical network organization, the association between connectivity and cognitive impairments in BD remains unclear.METHODS: We examined the role of anatomical network connectivity derived from Ti - and diffusion-weighted magnetic resonance imaging in impaired cognitive performance in individuals with BD (n = 32) compared with healthy control individuals (n = 38). Fractional anisotropy- and number of streamlines-weighted anatomical brain networks were generated by mapping constrained spherical deconvolution-reconstructed white matter among 86 cortical/subcortical bilateral brain regions delineated in the individual\u27s own coordinate space. Intelligence and executive function were investigated as distributed functions using measures of global, rich-club, and interhemispheric connectivity, while memory and social cognition were examined in relation to subnetwork connectivity.RESULTS: Lower executive functioning related to higher global clustering coefficient in participants with BD, and lower IQ performance may present with a differential relationship between global and interhemispheric efficiency in individuals with BD relative to control individuals. Spatial recognition memory accuracy and response times were similar between diagnostic groups and associated with basal ganglia and thalamus interconnectivity and connectivity within extended anatomical subnetworks in all participants. No anatomical subnetworks related to episodic memory, short-term memory, or social cognition generally or differently in BD.CONCLUSIONS: Results demonstrate selective influence of subnetwork patterns of connectivity in underlying cognitive performance generally and abnormal global topology underlying discrete cognitive impairments in BD.We gratefully acknowledge the participants, the support of the Welcome-Trust HRB
Clinical Research Facility, the Centre for Advanced Medical Imaging at St. James
Hospital Dublin and funding support from the Irish Research Council Government of
Ireland Postgraduate Scholarship. We would also like to thank Andrew Hoopes,
Research Technician I, MGH/HST Martinos Center for Biomedical Imaging for
Freesurfer software support, Christopher Grogan, MSc, for his contribution to data
processing and Jenna Pittman, BSc and Fiona Martyn, BA for their contribution to
data handling. This research was funded by the Health Research Board (HRA-POR324) awarded to Dara M. Cannon, PhD.2020-09-1
Utility of phase angle to identify cachexia and assess mortality in end-stage renal disease
Intraocular Pressure Lowering Effect of Latanoprost as First-line Treatment for Glaucoma
Purpose:To assess the intraocular pressure (IOP)-reducing effect of latanoprost in treatment-naĂŻve patients with newly detected open-angle glaucoma with no restriction of the level of untreated IOP.Methods:Eighty-six patients (105 eyes) with a diagnosis of open-angle glaucoma received IOP-lowering therapy with latanoprost. The IOP reduction 1 and 3 months after initiation of treatment was recorded.Results:Mean untreated IOP for all eyes was 26.2mm Hg (ranging from 10 to 51mm Hg). The mean pressure reduction was 7.9mm Hg (28%), with equivalent average levels at 1 and 3 months. The reduction in IOP ranged from â2.3 to 25.3mm Hg after 1 month, and from â1.3 to 33.3mm Hg after 3 months. The pressure-lowering effect was considerably more pronounced in eyes with higher untreated IOP; the reduction increased by 0.55mm Hg per mm Hg higher untreated IOP. Four eyes, with untreated IOP within statistically normal limits, had no or negative IOP-reduction. A regression model predicted that IOP reduction ended at untreated IOP â€16mm Hg. Multiple regression analysis showed that an additional IOP-lowering effect of 1.28mm Hg was achieved in eyes with pseudoexfoliation glaucoma.Conclusions:To the best of our knowledge, this paper is the first to report the IOP-reducing effect of latanoprost treatment at all untreated IOP levels in newly detected glaucoma patients. The effect was proportional to the untreated IOP at all levels above 16mm Hg and better at higher untreated IOP levels, also in relative terms. Our results further confirm the indication of latanoprost as a first-line therapy for glaucoma