P1071WITHIN-PATIENT RELATIONSHIPS BETWEEN ULTRAFILTRATION AND FLUID GAINS IN HAEMODIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Mai Nguyen ◽  
Richard Corbett ◽  
Neill Duncan ◽  
Damien Ashby
Keyword(s):  
Fluid Management ◽  
Dialysis Session ◽  
Patient Factors ◽  
Factors Affecting ◽  
Target Weight ◽  
One Year ◽  
Patient Relationships ◽  
Haemodialysis Treatment

Abstract Background and Aims Despite the now-widespread use of haemodialysis treatment, optimal fluid management in long-term dialysis patients remains challenging. Whilst the between-patient factors affecting target weight and ultrafiltration have been well studied, little is known regarding the within-patient factors affecting these relationships. Method Dialysis data for a group of stable haemodialysis patients, from 4 dialysis units, were analysed over a period of one year. All weights and volumes are expressed as percentage of target weight. Results From 100 patients (aged 28–89, mean 65.4, 54% male) observed over a year, complete data were available for 15530 dialysis sessions, and 13027 combinations of dialysis session plus the following inter-dialytic interval. Mean arterial pressure dropped by 3.5(+/-14.6)mmHg during dialysis, with a significant correlation (p<0.05) between pressure drop and ultrafiltration volume in 26 patients (mean R=0.09, mean regression gradient 3.2). In 87 patients, inter-dialytic fluid gain correlated strongly (p<0.05) with the previous dialysis session’s ultrafiltration volume (mean R=0.37, mean regression gradient 0.20) suggesting a significant role of ultrafiltration volume in driving subsequent fluid intake behaviour (thirst). Unsurprisingly, more fluid was gained over longer inter-dialytic intervals: mean(sd) weight at the start of dialysis was 103.2(1.0)% after a 3-day gap and 102.5(1.0)% after a 2-day gap, with this difference being significant (p<0.05) in 87 patients. However, fluid gain was non-linear, diminishing during longer inter-dialytic intervals: mean(sd) daily inter-dialytic fluid gain was 1.13(0.38)% during the 3-day gap vs 1.21(0.53)% during the 2-day gap (p<0.05 in 36 patients), implying that at least a third of patients consume less fluid during the 3rd post-dialysis day. Conclusion Inter-dialytic fluid gain is strongly dependent on ultrafiltration during the previous dialysis session, and diminishes during the inter-dialytic interval. Large ultrafiltration volumes, which have historically been perceived as the inevitable result of large fluid intakes, are actually a cause of thirst and large fluid intakes in haemodialysis patients. These data, derived from within-patient analyses, strongly challenge our conventional understanding of dialytic fluid management.

scholarly journals Role of methyleprednisolone succinate in the management of acute spinal cord injury

1970 ◽  
Vol 9 (3) ◽  
pp. 168-172
Author(s):  
NK Karn ◽  
BP Shrestha ◽  
GP Khanal ◽  
R Rijal ◽  
P Chaudhary ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Neurological Status ◽  
Acute Spinal Cord Injury ◽  
Cord Injury ◽  
And Gender ◽  
One Year

Objective: To see the role of methyleprednisolone succinate in the management of acute spinal cord injury. Methods: A randomized control trial was done including the patients with acute spinal cord injury. They were divided into age and gender matched two groups. Patients with presence of active infection, associated open fracture, those on long term steroid and those who did not give consent to participate in the trial were excluded. One group received methyleprednisolone succinate within 8 hours of injury and another group did not receive the drug. Both the groups were managed nonoperatively. The neurological status of the patients was assessed at presentation, once spinal shock was over, at 6th week and 6th month and after one year according to ASIA scoring. Frankel grading was also assessed in every follow up. Conclusion: Methylprednisolone succinct prevents secondary cord injury to a great extent and hence its administration within 8 hours of injury results in a better functional (motor and sensory) outcome. Keywords: acute spinal cord injury; methyleprednisolone succinate DOI: http://dx.doi.org/10.3126/hren.v9i3.5585   HR 2011; 9(3): 168-172

scholarly journals Effects of Fire and Large Herbivores on Canopy Nitrogen in a Tallgrass Prairie

2019 ◽  
Vol 11 (11) ◽  
pp. 1364 ◽  
Author(s):  
Bohua Ling ◽  
Edward J. Raynor ◽  
Douglas G. Goodin ◽  
Anthony Joern
Keyword(s):  
Spatial Variability ◽  
Nitrogen Content ◽  
Tallgrass Prairie ◽  
High Nitrogen Content ◽  
High Nitrogen ◽  
Grazing History ◽  
One Year ◽  
Canopy Nitrogen

This study analyzed the spatial heterogeneity of grassland canopy nitrogen in a tallgrass prairie with different treatments of fire and ungulate grazing (long-term bison grazing vs. recent cattle grazing). Variogram analysis was applied to continuous remotely sensed canopy nitrogen images to examine the spatial variability in grassland canopies. Heterogeneity metrics (e.g., the interspersion/juxtaposition index) were calculated from the categorical canopy nitrogen maps and compared among fire and grazing treatments. Results showed that watersheds burned within one year had higher canopy nitrogen content and lower interspersions of high-nitrogen content patches than watersheds with longer fire intervals, suggesting an immediate and transient fire effect on grassland vegetation. In watersheds burned within one year, high-intensity grazing reduced vegetation density, but promoted grassland heterogeneity, as indicated by lower canopy nitrogen concentrations and greater interspersions of high-nitrogen content patches at the grazed sites than at the ungrazed sites. Variogram analyses across watersheds with different grazing histories showed that long-term bison grazing created greater spatial variability of canopy nitrogen than recent grazing by cattle. This comparison between bison and cattle is novel, as few field experiments have evaluated the role of grazing history in driving grassland heterogeneity. Our analyses extend previous research of effects from pyric herbivory on grassland heterogeneity by highlighting the role of grazing history in modulating the spatial and temporal distribution of aboveground nitrogen content in tallgrass prairie vegetation using a remote sensing approach. The comparison of canopy nitrogen properties and the variogram analysis of canopy nitrogen distribution provided by our study are useful for further mapping grassland canopy features and modeling grassland dynamics involving interplays among fire, large grazers, and vegetation communities.

scholarly journals Rural Households’ Poverty and Relocation and Settlement: Evidence from Western China

2019 ◽  
Vol 16 (14) ◽  
pp. 2609 ◽  
Author(s):  
Wei Liu ◽  
Jie Xu ◽  
Jie Li ◽  
Shuzhuo Li
Keyword(s):  
Logistic Model ◽  
Rural Households ◽  
Western China ◽  
Multinomial Logistic Model ◽  
Factors Affecting ◽  
Chronic Poverty ◽  
Southern Shaanxi ◽  
Transient Poverty

Based on survey data collected from five counties across southern Shaanxi, China, the present study employs a multinomial logistic model to explore the main factors related to the type of poverty of rural households, particularly focusing on the role of relocation time, reason for relocation, and type of relocation. The results showed that three types of poverty, “voluntary poverty”, “transient poverty”, and “chronic poverty”, are distinguished by combining income and consumption criteria. Moreover, relocation and settlement programs contribute to a certain degree to these three kinds of poverty, and the effects vary according to the relocation characteristics. Specifically, those relocated long-term were more likely to be trapped in “voluntary poverty” and “chronic poverty”, whereas those relocated short-term were less likely to fall into “voluntary poverty” and “transient poverty”. The poverty alleviation and disaster-related resettlers were less likely to be trapped in “chronic poverty”, whereas centralized resettlers were less likely to be trapped in “voluntary poverty” and “chronic poverty”. Additionally, demographic characteristics, capital endowment variables, and geographical features are all important factors affecting rural households’ type of poverty. This study can serve as a reference for further resettlement practice in China and other developing countries.

scholarly journals Return to Work Among Stroke Survivors

2019 ◽  
Vol 67 (2) ◽  
pp. 87-94 ◽  
Author(s):  
Kristin D. Ashley ◽  
Loretta T. Lee ◽  
Karen Heaton
Keyword(s):  
Occupational Health ◽  
Return To Work ◽  
Quantitative Research ◽  
Stroke Severity ◽  
Stroke Survivors ◽  
Factors Affecting ◽  
Work And Employment ◽  
Subsequent Failure

Despite improvements in the treatment of stroke, many individuals still face cognitive, emotional, and physical impairments. Stroke is a leading cause of serious long-term disability and subsequent failure to return to work (RTW). The purpose of this literature review was to synthesize and discuss the literature relevant to factors affecting RTW for stroke survivors, summarize the identified gaps, and discuss steps occupational health nurses can take to facilitate RTW among stroke survivors. A literature search was conducted using the keywords: “stroke,” “cerebrovascular disease,” “return to work,” and “employment.” After excluding articles based on inclusion/exclusion criteria, 19 quantitative research articles were reviewed. Consistent themes found in the literature affecting RTW following stroke included physical, social, and cognitive factors. One of the most consistent predictors of RTW found was stroke severity. Individuals who experienced a mild to moderate stroke, those of Caucasian ethnicity, and higher socioeconomic levels were more likely to RTW. Findings suggest the importance of future studies to examine factors among African American stroke survivors that predict RTW and the role of occupational health nurses.

Long-term changes in rumen fermentation in defaunated sheep

1991 ◽  
Vol 1991 ◽  
pp. 77-77
Author(s):  
P.P. Frumholtz ◽  
R.J. Wallace ◽  
C.J. Newbold ◽  
E.R. Ørskov
Keyword(s):  
Animal Species ◽  
Fish Meal ◽  
Jugular Vein ◽  
Rumen Fermentation ◽  
Bacteria And Fungi ◽  
One Year ◽  
The Stability ◽  
Ciliate Protozoa

The removal of ciliate protozoa, or defaunation, results in the establishment of a new ecosystem in the rumen, consisting only of bacteria and fungi. Although extensive research has been done on ciliate-free ruminants, the role of protozoa in the rumen still provokes considerable debate. The diversity of experimental design, such as animal species, defaunation method, and diet could account for many of the differences observed between defaunation studies. Also it is important to examine the stability of the ciliate-free ecosystem. The aim of this study was to investigate changes in rumen fermentation of ciliate-free sheep over a period of one year.Eight male castrated sheep, weighing 60-70 kg, received twice daily 700 g of a diet of hay, barley, molasses, fish meal and vitamins/minerals (500, 299.5, 100, 91 and 9.5 g/kg DM respectively). Four sheep were defaunated by the rumen washing technique (Jouany and Senaud, 1979) and kept in isolated pens while the other four were left faunated with a mixed type A ciliate protozoa population. Rumen samples were withdrawn via the rumen cannula and blood samples were taken from the jugular vein -1, 0, 1, 2, 4 and 6 h after feeding. There were three sampling periods: one month, six months and one year after defaunation.

Knowledge Utilisation in AgriFood SMEs: Effects of Organisational and Informational Factors

2020 ◽  
Vol 8 (7) ◽  
pp. 235-248
Author(s):  
David Eshun Yawson
Keyword(s):  
Critical Role ◽  
User Interaction ◽  
Consumer Information ◽  
Partial Least Squares Analysis ◽  
Factors Affecting ◽  
Knowledge Utilisation ◽  
The Uk ◽  
Role Of Information

Given the critical role of information and marketing in SME management it is surprising that little attention has been paid to the salient factors that motivate or inhibits consumer information used by agrifood SMEs. A model of organisational and informational factors affecting knowledge utilisation in Agri-food SMEs is presented and empirically tested through partial least squares analysis via SmartPLS. The results of the empirical testing of the conceptual model provide evidence to indicate that functional and technical qualities, provider-user interaction and usefulness in the market environment are determinants of knowledge utilisation. The findings of this study have implications for agri-food SME management in the UK regarding their growth and competitiveness in the medium and long term.

THE PROFILE OF MULTIPLE SCLEROSIS IN GENERAL PRACTICE

2015 ◽  
Vol 86 (11) ◽  
pp. e4.6-e4
Author(s):  
Sophie Binks ◽  
Liz Green
Keyword(s):  
Multiple Sclerosis ◽  
Primary Care ◽  
Team Approach ◽  
Improvement Project ◽  
Flu Vaccination ◽  
The Mean ◽  
One Year ◽  
Primary Care Professionals

IntroductionMultiple sclerosis (MS) is a long-term neurological condition requiring a multi-disciplinary team approach. Recently, NICE highlighted the role of primary care professionals in MS management through an updated clinical guideline. This quality improvement project investigated aspects of MS patient care in a large Brighton GP practice.MethodElectronic GP records were searched to identify all currently registered patients with a diagnosis of MS. Details of initial presentation, epidemiology and care received over a one-year period were examined.ResultsThere were 19 patients, representing a prevalence of 186 per 100,000. Most patients first presented in GP with sensory disturbance, optic neuritis or motor symptoms. The mean number of primary care contacts per patient per year was 4.3, compared to 0.4 contacts per person per year with a neurologist and 0.5 with the MS nurse. 46% of GP consultations were wholly or partially related to the patient's MS. Around half of patients took up proactive interventions such as flu vaccination (47%) and Vitamin D monitoring (50%).ConclusionsPrimary care professionals are significant contributors to the care of people with MS with frequent patient contact. During this project, patients were reminded of preventive care opportunities and this will be re-audited in 2015.

scholarly journals A retrospective study of various factors affecting infertility in Rajasthan, India

2020 ◽  
Vol 9 (7) ◽  
pp. 2910
Author(s):  
Preksha T. Singh ◽  
Saroj Choudhary ◽  
Shreyans D. Singhvi
Keyword(s):  
Retrospective Study ◽  
Reproductive Organs ◽  
Factors Affecting ◽  
Sperm Abnormality ◽  
Ultrasound Sonography ◽  
Early Case ◽  
Psychological Impairment ◽  
One Year ◽  
Biochemical Examination

Background: Infertility is seen fairly common in these days and it cause not only reproductive but also psychological impairment of the parents. Infertility leads to multitude of personal as well as societal repercussions. There are various advances in technology which help the parents suffering from infertility. Infertility is defined as the failure to conceive after one year of regular intercourse in women <35 years not using contraception and after six months in women >35 years.Methods: A retrospective study of 400 females and their husbands’ coming to the department of gynecology, Umaid Hospital, Jodhpur, Rajasthan was undertaken from February 2020 to March 2020. A structural self-constructed questionnaire was used in the study. A well-informed verbal consent was taken by the participants of the study. It had open and closed ended questions. Further, an ultrasound sonography (USG) was performed to check the reproductive organs of the patient, to find the cause of infertility, as well as biochemical examination on male sperm, was performed to find out the sperm abnormality, ejection disorders and other long-term illness.Results: In our study, we found multiple factors affecting infertility issues in females. These factors were- menstrual cycle abnormally, bleeding abnormality and years of active married life. We also found Polycystic ovarian disorder as a major underlying cause of female infertility and sperm abnormality as a major cause of male infertility.Conclusions: Authors recommend frequent female routine checkups to asses early case of infertility and treat it as early as possible.

scholarly journals Mycobacteriosis treatment challenges in patients with HIV-infection

2020 ◽  
Vol 12 (3) ◽  
pp. 35-45
Author(s):  
M. A. Savchenko ◽  
A. M. Panteleev
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
The United States ◽  
Steady Increase ◽  
The Past ◽  
Highly Active ◽  
History Of ◽  
One Year

Over the past decade, in Russian Federation there has been a steady increase in the incidence of MAC-infection in patients with HIV (the growth of nosology over the past five years, on average, was 57% per year). This determines the interest in this problem, especially in terms of the high inefficiency of treatment for the disease, the long term and cost of treatment. The history of the study of Mycobacterium Avium Complex-infection (MAC) originates in the early eighties in the United States, when the prognosis for a patient with AIDS and mycobacteriosis was extremely poor: mortality within one year after the detection of pathogen reached 71%. The role of infection in the thanatogenesis of patients was, however, established only by the beginning of the nineties. The detection of macrolide activity against the pathogen significantly improved the prognosis for patients, especially in combination with highly active antiretroviral therapy. The widespread introduction of antiviral drugs into practice and the ability to achieve immune reconstitution prevented the development of opportunistic infections, but did not solve the remaining issues of the treatment of the MAC-infection. The main one is the treatment of patients with a clarithromycin-resistant pathogen. There is no consensus on the sensitivity of non-tuberculous mycobacteria to antibacterials.

scholarly journals To evaluate the role of MRI in infants with suspected hypoxic ischemic encephalopathy and prognosticating neurological outcome at end of one year

2017 ◽  
Vol 5 (5) ◽  
pp. 1893
Author(s):  
Shreyas Ramachandran ◽  
Smiti Sripathi
Keyword(s):  
Clinical Outcome ◽  
Motor Development ◽  
Perinatal Asphyxia ◽  
Hypoxic Ischemic Encephalopathy ◽  
Neurological Outcomes ◽  
Common Causes ◽  
One Year ◽  
Ischemic Encephalopathy

Background: Hypoxic ischemic encephalopathy (HIE) is one the common causes of neonatal fatality due to perinatal asphyxia. The long-term outcomes of HIE are impaired mental and motor development, hearing loss, recurrent seizures and cerebral palsy. MRI is increasingly becoming the gold standard in diagnosis of HIE as it involves no radiation and can be performed during a neonates physiological sleep. To evaluate the role of MRI in infants with suspected hypoxic ischemic encephalopathy in prognosticating neurological outcomes at end of one year.Methods: A total of 50 patients were included in the study who underwent MRI of brain. A clinical follow up was done at the end of one year.Results: The sensitivity of MRI in prognosticating clinical outcome was 72% and specificity was 71% while PPV and NPV was 86% and 50% respectively.Conclusions: MRI is a useful modality to assess early changes in HIE and it can prognosticate clinical outcome.

Sign in / Sign up

Export Citation Format

Share Document