The effectiveness of locally-prepared peritoneal dialysate in the management of children with acute kidney injury in a south-east Nigerian tertiary hospital

Background: Peritoneal dialysis (PD) is the preferred mode of renal replacement therapy (RRT) in children with acute kidney injury (AKI). The gold standard remains the use of commercially-prepared PD fluid. In resource-poor nations, its availability and affordability remain a challenge.Aim: This study aims to report the effectiveness of locally-prepared PD fluid in the management of AKI in a south-east Nigerian tertiary hospital.Subjects and Methods: This was a retrospective study conducted at the paediatric ward of the University of Nigeria Teaching hospital, Enugu. The case records of 36 children seen over three years, diagnosed with AKI and requiring PD were reviewed. The retrieved information comprised biodata, aetiology of AKI, indications for PD, pre-and post-dialysis estimated glomerular filtration rate (eGFR) and patient outcomes.Results: The children (20 males and 16 females) were aged 3 to 36 months with a mean age of 9.92 ± 6.29 months. The common aetiologies of AKI were septicemia (30.6%), hemolytic uremic syndrome (19.4%), and toxic nephropathy (16.7%). The frequent indications for PD were uremic encephalopathy (58.3%) and severe metabolic acidosis (38.8%). The pre-and post-dialysis mean urine flow rate was 0.16 + 0.13 and 2.77 + 0.56 ml/kg/hour respectively. The eGFR before PD, at discontinuation, and a week later was 6.06 + 2.87, 24.44 + 15.71 and 59.07 + 22.22 mls/min/1.73m2 respectively.Conclusion: PD with locally-prepared dialysate is safe, effective and a life-saving alternative in the management of AKI in childrenKeywords: Peritoneal dialysis; renal replacement therapy; acute kidney injury; children; dialysate; developing country

Comparable endocrine and neuromuscular adaptations to variable vs. constant gravity-dependent resistance training among young women.

BACKGROUND:Variable resistance has been shown to induce greater total work and muscle activation when compared to constant resistance. However, little is known regarding the effects of chronic exposure to variable resistance training in comparison with constant resistance training. The aim of the present study was therefore to examine the effects of chain-loaded variable and constant gravity-dependent resistance training on resting hormonal and neuromuscular adaptations. METHODS:Young women were randomly assigned to variable resistance training (VRT; n = 12; age, 23.75 ± 3.64 years; and BMI, 26.80 ± 4.21 kg m-2), constant resistance training (CRT; n = 12; age, 23.58 ± 3.84 years; BMI, 25.25 ± 3.84 kg m-2), or control (Con; n = 12; age, 23.50 ± 2.93 years; BMI, 27.12 ± 12 kg m-2) groups. CRT performed 8-week total-body free-weight training three times per week with moderate-to-high intensity (65-80% 1RM; periodized). VRT was the same as CRT but included variable resistance via chains (15% of total load). Resting serum samples were taken before and after the 8-week intervention for GH, IGF-1, cortisol, myostatin, and follistatin analyses. RESULTS:Both VRT and CRT groups displayed moderate-to-large significant increases in GH (197.1%; ES = 0.78 vs. 229.9%; ES = 1.55), IGF-1 (82.3%; ES = 1.87 vs. 66%; ES = 1.66), and follistatin (58.8%; ES = 0.80 vs. 49.15%; ES = 0.80) and decreases in cortisol (- 19.9%; ES = - 1.34 vs. - 17.1%; ES = - 1.05) and myostatin (- 26.9%; ES = - 0.78 vs. - 23.2%; ES = - 0.82). Also, VRT and CRT resulted in large significant increases in bench press (30.54%; ES = 1.45 vs. 25.08%; ES = 1.12) and squat (30.63%; ES = 1.28 vs. 24.81%; ES = 1.21) strength, with no differences between groups. CONCLUSIONS:Implementing chain-loaded VRT into a periodized resistance training program can be an effective alternative to constant loading during free-weight RT among untrained young women

Not Available

Not AvailableField screening of 83 groundnut cultivars was undertaken for two seasons to assess their tolerance of salinity based on plant mortality and yield attributes. During the dry season, soil salinity of 4 dS m−1 at sowing and 6–7 dS m−1 21–98 days after sowing (DAS) caused high mortality without seed formation in any cultivars, however, at salinity 4.5 dS m−1 during sowing and 3.5–3.0 dS m−1 15–80 DAS during wet season, 61 cultivars produced seed. The cultivars ‘VRI 3’, ‘UF 70–103’, ‘TKG 19A’, ‘S 206’, ‘Tirupati 4’, ‘M 522’, ‘Punjab 1’, ‘BG 3’, ‘Somnath’ and ‘ICGV 86590’, with high plant stand during both the seasons and over 75 g m−2 seed yield during wet season, were identified salinity tolerant. However, 15 cultivars with more than 50 g m−2 seed yield were moderately tolerant and 28 cultivars with less than 25 g m−2 seed yield were sensitive to salinityNot Availabl

Not Available

Not AvailableThe epicuticularwax load (EWL) on leaves reduces surface transpi-ration and thus improves crop water use efficiency. The objectives of this study were to evaluate peanut (Arachis hypogaea L.) genotypes for their ELW and also to determine the influence of water deficit cultistress on EWL. Peanut genotypes were grown in fields in two dry sea-sons (2000 and 2001) and one rainy (2000) season. Withholding irrigation water resulted in a significant increase in water saturation deficit in the stressed crop. At 45 d after sowing (DAS), significant genotypic differences were observed in EWL of 12 genotypes grown in the rainy season (2000). The values of EWL ranged from 0.91mg dm 2 in Chico to 1.74 mg dm 2 in PBS 11049, with a mean of 1.27 mg dm 2. Among six genotypes, which were also sampled subsequently, themean values were 1.10, 1.58, 2.05 mg dm 2 at 45, 75, and 95 DAS, respectively. In both dry seasons, significant genotypic differences were found in the EWL. In the dry season of 2001, the effect of various moisture deficit treatments and their interactions with the genotypes were highly significant.Not Availabl

Clinical obesity services in public hospitals in Australia: a position statement based on expert consensus

We aimed to describe the current state of specialist obesity services for adults with clinically severe obesity in public hospitals in Australia, and to analyse the gap in resources based on expert consensus. We conducted two surveys to collect information about current and required specialist obesity services and resources using open-ended questionnaires. Organizational level data were sought from clinician expert representatives of specialist obesity services across Australia in 2017. Fifteen of 16 representatives of current services in New South Wales (n = 8), Queensland (n = 1), Victoria (n = 2), South Australia (n = 3), and the Australian Capital Territory (n = 1) provided data. The composition of services varied substantially between hospitals, and patient access to services and effective treatments were limited by strict entry criteria (e.g. body mass index 40 kg/m2 or higher with specific complication/s), prolonged wait times, geographical location (major cities only) and out-of-pocket costs. Of these services, 47% had a multidisciplinary team (MDT), 53% had an exercise physiologist/physiotherapist, 53% had a bariatric surgeon and 33% had pharmacotherapy resources. Key gaps included staffing components of the MDT (psychologist, exercise physiologist/physiotherapist) and access to publicly funded weight loss pharmacotherapy and bariatric surgery. There was consensus on the need for significant improvements in staff, physical infrastructure, access to services, education/training in obesity medicine and targeted research funding. Based on the small number of existing, often under-resourced specialist obesity services that are located only in a few major cities, the vast majority of Australians with clinically severe obesity cannot access the specialist evidence based treatments needed.E. Atlantis, N. Kormas, K. Samaras, P. Fahey, P. Sumithran, S. Glastras, G. Wittert, K. Fusco, R. Bishay, T. Markovic, L. Ding, K. Williams, I. Caterson, V. Chikani, P. Dugdale and J. Dixo