89 research outputs found
Bone mass does not correlate with the serum fibroblast growth factor 23 in hemodialysis patients
Circulating fibroblast growth factor 23 (FGF23) increases renal phosphate excretion, decreases bone mineralization and is markedly increased in hemodialysis patients. Bone cells express fibroblast growth receptor 1, suggesting that FGF23 could alter bone mineralization by means of a direct effect on the skeleton and/or secondarily due to hypophosphatemia. To distinguish between these possibilities we measured serum concentrations of FGF23, parathyroid hormone, phosphate, calcium, and markers of bone remodeling, and assessed bone mineral density in 99 hemodialysis patients. FGF23 concentrations were increased in all hemodialysis patients, even in those without hyperphosphatemia, and positively correlated with serum phosphate but not with parathyroid hormone. Hemodialysis did not decrease the serum FGF23 concentration. We found no significant correlation between serum FGF23 levels and bone mineral density. Further analysis by gender or T-score did not modify these results. Serum markers of bone remodeling significantly correlated with parathyroid hormone but not with FGF23 levels. The increase in serum FGF23 concentration in hemodialysis patients cannot be solely ascribed to hyperphosphatemia. Our study suggests that the effects of FGF23 on bone mineralization are mainly due to hypophosphatemia and not a direct effect on bone
Circulating markers of bone turnover
Renal osteodystrophy is a feature of chronic kidney disease (CKD), with increasing prevalence as CKD progresses. This bone disease is responsible for major morbidity, including fractures, and a deterioration in the quality of life and its sequelae. Circulating biomarkers of renal osteodystrophy typically indicate bone turnover, but not other features of bone, like bone volume, mineralization, quality or strength. Bone turnover can be considered to be primarily a reflection of bone cell activity, in particular that of osteoblasts and osteoclasts. Since current treatments for bone disease usually target cellular activity, biomarkers are considered to be able to contribute to the decision-making for treatment and its follow-up. In CKD, one has to consider the impact of a diminished clearance of biomarkers or their altered metabolism, both potentially limiting its clinical use. Here, several aspects of the most frequently used biomarkers of bone turnover are reviewed, with an emphasis on the specific situation represented by CKD. This review is based on the overview lecture at the symposium held in Amsterdam, September 23, 2016: "The Bone In CKD", organized by the CKD-MBD working group of ERA-EDTA
Blueprint for a European calciphylaxis registry initiative: European Calciphylaxis Network (EuCalNet)
Calcific uraemic arteriolopathy (CUA) is a rare disease and continues to be a clinical challenge. The typical course of CUA is
characterized by painful skin discolouration and induration evolving to necrotic ulcerations. Medial calcification of cutaneous
arterioles and extensive extracellular matrix remodelling are the hallmarks of CUA. The epidemiology and risk factors
associated with this disease are still not fully understood. Moreover, CUA treatment strategies vary significantly among centres
and expert recommendations are heterogeneous. Registries may provide important insights and information to increase our
knowledge about epidemiology and clinical aspects of CUA and may help to optimize its therapeutic management. In 2006, we
established an internet-based registry in Germany (www.calciphylaxie.de) to allow online notification of patients with
established or suspected CUA. The registry includes a comprehensive database with questions covering >70 parameters and
items regarding patient-related and laboratory data, clinical background and presentation as well as therapeutic strategies. The
next phase will be to allow international patient registration via www.calciphylaxis.net as part of the multinational EuCalNet
(European Calciphylaxis Network) initiative, which is supported by the ERA-EDTA scientific working group \u2018CKD-MBD\u2019. Based on
the valuable experience with the previous German CUA registry, EuCalNet will be a useful tool to collect data on the rare disease
CUA and may become a basis for prospective controlled trials in the near future
Cosmological models in scalar tensor theories of gravity and observations: a class of general solutions
We consider cosmological models in scalar tensor theories of gravity that
describe an accelerating universe, and we study a family of inverse power law
potentials, for which exact solutions of the Einstein equations are known. We
also compare theoretical predictions of our models with observations. For this
we use the following data: the publicly available catalogs of type Ia
supernovae and high redshift Gamma Ray Bursts, the parameters of large scale
structure determined by the 2-degree Field Galaxy Redshift Survey (2dFGRS), and
measurements of cosmological distances based on the Sunyaev-Zel'dovich effect,
among others.Comment: 26 pages,23 figures, accepted for publication in A&
Galactic Gamma-Ray Diffuse Emission at TeV energies with HAWC Data
The Galactic gamma-ray diffuse emission (GDE) is emitted by cosmic rays
(CRs), ultra-relativistic protons and electrons, interacting with gas and
electromagnetic radiation fields in the interstellar medium. Here we present
the analysis of TeV diffuse emission from a region of the Galactic Plane over
the range in longitude of , using data collected with
the High Altitude Water Cherenkov (HAWC) detector. Spectral, longitudinal and
latitudinal distributions of the TeV diffuse emission are shown. The radiation
spectrum is compatible with the spectrum of the emission arising from a CR
population with an "index" similar to that of the observed CRs. When comparing
with the \texttt{DRAGON} \textit{base model}, the HAWC GDE flux is higher by
about a factor of two. Unresolved sources such as pulsar wind nebulae and TeV
halos could explain the excess emission. Finally, deviations of the Galactic CR
flux from the locally measured CR flux may additionally explain the difference
between the predicted and measured diffuse fluxes
The TeV Sun Rises: Discovery of Gamma rays from the Quiescent Sun with HAWC
We report the first detection of a TeV gamma-ray flux from the solar disk
(6.3), based on 6.1 years of data from the High Altitude Water
Cherenkov (HAWC) observatory. The 0.5--2.6 TeV spectrum is well fit by a power
law, dN/dE = , with TeV cm s and . The flux
shows a strong indication of anticorrelation with solar activity. These results
extend the bright, hard GeV emission from the disk observed with Fermi-LAT,
seemingly due to hadronic Galactic cosmic rays showering on nuclei in the solar
atmosphere. However, current theoretical models are unable to explain the
details of how solar magnetic fields shape these interactions. HAWC's TeV
detection thus deepens the mysteries of the solar-disk emission.Comment: 15 pages, 8 figures including supplementary material. Accepted for
publication in Physical Review Letter
Micromechanical Properties of Injection-Molded Starch–Wood Particle Composites
The micromechanical properties of injection molded starch–wood particle composites were investigated as a function of particle content and humidity conditions.
The composite materials were characterized by scanning electron microscopy and X-ray diffraction methods. The microhardness
of the composites was shown to increase notably with the concentration of the wood particles. In addition,creep behavior under the indenter and temperature dependence
were evaluated in terms of the independent contribution of the starch matrix and the wood microparticles to the hardness value. The influence of drying time on the density
and weight uptake of the injection-molded composites was highlighted. The results revealed the role of the mechanism of water evaporation, showing that the dependence of water uptake and temperature was greater for the starch–wood composites than for the pure starch sample. Experiments performed during the drying process at 70°C indicated that
the wood in the starch composites did not prevent water loss from the samples.Peer reviewe
Mortality and pulmonary complications in patients undergoing surgery with perioperative sars-cov-2 infection: An international cohort study
Background The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (740%) had emergency surgery and 280 (248%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (261%) patients. 30-day mortality was 238% (268 of 1128). Pulmonary complications occurred in 577 (512%) of 1128 patients; 30-day mortality in these patients was 380% (219 of 577), accounting for 817% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 175 [95% CI 128-240], p<00001), age 70 years or older versus younger than 70 years (230 [165-322], p<00001), American Society of Anesthesiologists grades 3-5 versus grades 1-2 (235 [157-353], p<00001), malignant versus benign or obstetric diagnosis (155 [101-239], p=0046), emergency versus elective surgery (167 [106-263], p=0026), and major versus minor surgery (152 [101-231], p=0047). Interpretation Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research
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