57 research outputs found

    Renal Replacement Therapy and Incremental Hemodialysis for Veterans with Advanced Chronic Kidney Disease.

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    Each year approximately 13,000 Veterans transition to maintenance dialysis, mostly in the traditional form of thrice-weekly hemodialysis from the start. Among >6000 dialysis units nationwide, there are currently approximately 70 Veterans Affairs (VA) dialysis centers. Given this number of VA dialysis centers and their limited capacity, only 10% of all incident dialysis Veterans initiate treatment in a VA center. Evidence suggests that, among Veterans, the receipt of care within the VA system is associated with favorable outcomes, potentially because of the enhanced access to healthcare resources. Data from the United States Renal Data System Special Study Center "Transition-of-Care-in-CKD" suggest that Veterans who receive dialysis in a VA unit exhibit greater survival compared with the non-VA centers. Substantial financial expenditures arise from the high volume of outsourced care and higher dialysis reimbursement paid by the VA than by Medicare to outsourced providers. Given the exceedingly high mortality and abrupt decline in residual kidney function (RKF) in the first dialysis year, it is possible that incremental transition to dialysis through an initial twice-weekly hemodialysis regimen might preserve RKF, prolong vascular access longevity, improve patients' quality of life, and be a more patient-centered approach, more consistent with "personalized" dialysis. Broad implementation of incremental dialysis might also result in more Veterans receiving care within a VA dialysis unit. Controlled trials are needed to examine the safety and efficacy of incremental hemodialysis in Veterans and other populations; the administrative and health care as well as provider structure within the VA system would facilitate the performance of such trials

    Quality of Life in Men With Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency

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    Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21OHD) is a disorder of adrenal steroid biosynthesis, leading to hypocortisolism, hypoaldosteronism, and hyperandrogenism. Impaired quality of life (QoL) has been demonstrated in women with CAH, but data on men with CAH are scarce. We hypothesized that disease severity and poor treatment control are inversely associated with QoL. In this study, 109 men (16-68 years) with 21OHD were included. The WHOQOL-BREF questionnaire was used to measure self-reported QoL domain scores on a 0-100 scale, where higher scores reflect better QoL. QoL domain scores were compared to published data on healthy and chronically ill reference populations from France, Germany, the Netherlands, and the United Kingdom. Differences in QoL scores among groups of disease severity and treatment control were tested within the study population. Overall, the men with CAH in this study appeared to rate their QoL as good. Median domain scores were 78.6 (IQR: 67.9-85.7) for physical health, 79.2 (IQR: 66.7-87.5) for psychological health, 75.0 (IQR: 58.3-83.3) for social relationships, and 81.3 (IQR: 71.9-90.6) for environment. In general, these scores were similar to WHOQOL-BREF domain scores in healthy references and higher compared to chronically ill reference populations. The domain scores did not differ among genotype groups, but patients with undertreatment or increased 17-hydroxyprogestrone concentrations scored higher on several QoL domains (p<0.05). Patients treated with dexamethasone or prednisone scored higher on the physical health, psychological health, and social relationships domains, but not on the environmental domain. In conclusion, QoL domain scores appeared to be comparable to healthy reference populations and higher compared to patients with a chronic illness. QoL was not influenced by genotype, but undertreatment and use of dexamethasone or prednisone were associated with higher QoL

    Mobile Media Use : Structure and Order - Three Project Reports

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    In diesem Band werden drei empirische Forschungsprojekte zur Nutzung von mobilen Medien im öffentlichen Raum dokumentiert. Projekt I: "Einsteigen mit Medien. Eine Studie zur Nutzung mobiler Medien im öffentlichen Stadtverkehr am Beispiel der Landeshauptstadt Stuttgart" / Projekt II: "Angst vor der Langeweile? Nutzung mobiler Medien in Wartesituationen" / Projekt III: "Musica Mobilis. Unterwegs mit der schwerelosen Musiksammlung. Eine Studie über die Auswirkungen des mobilen Musikkonsums auf die Wertschätzung von Musik

    Using enhanced number and brightness to measure protein oligomerization dynamics in live cells

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    Protein dimerization and oligomerization are essential to most cellular functions, yet measurement of the size of these oligomers in live cells, especially when their size changes over time and space, remains a challenge. A commonly used approach for studying protein aggregates in cells is number and brightness (N&B), a fluorescence microscopy method that is capable of measuring the apparent average number of molecules and their oligomerization (brightness) in each pixel from a series of fluorescence microscopy images. We have recently expanded this approach in order to allow resampling of the raw data to resolve the statistical weighting of coexisting species within each pixel. This feature makes enhanced N&B (eN&B) optimal for capturing the temporal aspects of protein oligomerization when a distribution of oligomers shifts toward a larger central size over time. In this protocol, we demonstrate the application of eN&B by quantifying receptor clustering dynamics using electron-multiplying charge-coupled device (EMCCD)-based total internal reflection microscopy (TIRF) imaging. TIRF provides a superior signal-to-noise ratio, but we also provide guidelines for implementing eN&B in confocal microscopes. For each time point, eN&B requires the acquisition of 200 frames, and it takes a few seconds up to 2 min to complete a single time point. We provide an eN&B (and standard N&B) MATLAB software package amenable to any standard confocal or TIRF microscope. The software requires a high-RAM computer (64 Gb) to run and includes a photobleaching detrending algorithm, which allows extension of the live imaging for more than an hour

    Development of Metal–Organic Nanotubes Exhibiting Low-Temperature, Reversible Exchange of Confined “Ice Channels”

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    Nanotubular materials have unique water transport and storage properties that have the potential to advance separations, catalysis, drug delivery, and environmental remediation technologies. The development of novel hybrid materials, such as metal–organic nanotubes (MONs), is of particular interest, as these materials are amenable to structural engineering strategies and may exhibit tunable properties based upon the presence of inorganic components. A novel metal–organic nanotube, (C<sub>4</sub>H<sub>12</sub>N<sub>2</sub>)<sub>0.5</sub>[(UO<sub>2</sub>)­(H<i>ida</i>)­(H<sub>2</sub><i>ida</i>)]·2H<sub>2</sub>O (<b>UMON</b>) (<i>ida</i> = iminodiacetate), that demonstrates the possibilities of these types of hybrid compounds has been synthesized via a supramolecular approach. Single-crystal X-ray diffraction of the compound revealed stacked macrocyclic arrays that contain highly ordered water molecules with structural similarities to the “ice channels” observed in single-walled carbon nanotubes. Nanoconfinement of the water molecules may be the cause of the unusual exchange properties observed for <b>UMON</b>, including selectivity to water and reversible exchange at low temperature (37 °C). Similar properties have not been reported for other inorganic or hybrid compounds and indicate the potential of MONs as advanced materials

    Development of Metal–Organic Nanotubes Exhibiting Low-Temperature, Reversible Exchange of Confined “Ice Channels”

    No full text
    Nanotubular materials have unique water transport and storage properties that have the potential to advance separations, catalysis, drug delivery, and environmental remediation technologies. The development of novel hybrid materials, such as metal–organic nanotubes (MONs), is of particular interest, as these materials are amenable to structural engineering strategies and may exhibit tunable properties based upon the presence of inorganic components. A novel metal–organic nanotube, (C<sub>4</sub>H<sub>12</sub>N<sub>2</sub>)<sub>0.5</sub>[(UO<sub>2</sub>)­(H<i>ida</i>)­(H<sub>2</sub><i>ida</i>)]·2H<sub>2</sub>O (<b>UMON</b>) (<i>ida</i> = iminodiacetate), that demonstrates the possibilities of these types of hybrid compounds has been synthesized via a supramolecular approach. Single-crystal X-ray diffraction of the compound revealed stacked macrocyclic arrays that contain highly ordered water molecules with structural similarities to the “ice channels” observed in single-walled carbon nanotubes. Nanoconfinement of the water molecules may be the cause of the unusual exchange properties observed for <b>UMON</b>, including selectivity to water and reversible exchange at low temperature (37 °C). Similar properties have not been reported for other inorganic or hybrid compounds and indicate the potential of MONs as advanced materials

    Development of Metal–Organic Nanotubes Exhibiting Low-Temperature, Reversible Exchange of Confined “Ice Channels”

    No full text
    Nanotubular materials have unique water transport and storage properties that have the potential to advance separations, catalysis, drug delivery, and environmental remediation technologies. The development of novel hybrid materials, such as metal–organic nanotubes (MONs), is of particular interest, as these materials are amenable to structural engineering strategies and may exhibit tunable properties based upon the presence of inorganic components. A novel metal–organic nanotube, (C<sub>4</sub>H<sub>12</sub>N<sub>2</sub>)<sub>0.5</sub>[(UO<sub>2</sub>)­(H<i>ida</i>)­(H<sub>2</sub><i>ida</i>)]·2H<sub>2</sub>O (<b>UMON</b>) (<i>ida</i> = iminodiacetate), that demonstrates the possibilities of these types of hybrid compounds has been synthesized via a supramolecular approach. Single-crystal X-ray diffraction of the compound revealed stacked macrocyclic arrays that contain highly ordered water molecules with structural similarities to the “ice channels” observed in single-walled carbon nanotubes. Nanoconfinement of the water molecules may be the cause of the unusual exchange properties observed for <b>UMON</b>, including selectivity to water and reversible exchange at low temperature (37 °C). Similar properties have not been reported for other inorganic or hybrid compounds and indicate the potential of MONs as advanced materials
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