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WOS: 000398117600023, PubMed ID: 28025382, Background. From an individual participant data (IPD) meta-analysis from four randomized controlled trials comparing haemodialysis (HD) with post-dilution online-haemodiafiltration (ol-HDF), previously it appeared that HDF decreases all-cause mortality by 14% (95% confidence interval 25; 1) and fatal cardiovascular disease (CVD) by 23% (39; 3). Significant differences were not found for fatal infections and sudden death. So far, it is unclear, however, whether the reduced mortality risk of HDF is only due to a decrease in CVD events and if so, which CVD in particular is prevented, if compared with HD. Methods. The IPD base was used for the present study. Hazard ratios and 95% confidence intervals for cause-specific mortality overall and in thirds of the convection volume were calculated using the Cox proportional hazard regression models. Annualized mortality and numbers needed to treat (NNT) were calculated as well. Results. Besides 554 patients dying from CVD, fatal infections and sudden death, 215 participants died from 'other causes', such as withdrawal from treatment and malignancies. In this group, the mortality risk was comparable between HD and ol-HDF patients, both overall and in thirds of the convection volume. Subdivision of CVD mortality in fatal cardiac, non-cardiac and unclassified CVD showed that ol-HDF was only associated with a lower risk of cardiac casualties [0.64 (0.61; 0.90)]. Annual mortality rates also suggest that the reduction in CVD death is mainly due to a decrease in cardiac fatalities, including both ischaemic heart disease and congestion. Overall, 32 and 75 patients, respectively, need to be treated by high-volume HDF (HV-HDF) to prevent one all-cause and one CVD death, respectively, per year. Conclusion. The beneficial effect of ol-HDF on all-cause and CVD mortality appears to be mainly due to a reduction in fatal cardiac events, including ischaemic heart disease as well as congestion. In HV-HDF, the NNT to prevent one CVD death is 75 per year., EuDial working group; European Nephrology and Dialysis Institute; Catalan Society of Nephrology; Fresenius Medical Care; Dutch Kidney Foundation [C02.2019]; Fresenius Medical Care, Netherlands; Gambro Lundia AB, Sweden; Dr E.E. Twiss Fund; International Society of Nephrology/Baxter Extramural Grant Program; Netherlands Organization for Health Research and DevelopmentNetherlands Organization for Health Research and Development [170882802]; national grant from the Health Ministry (Programme Hospitalier de Recherche Clinique, PHRC); Gambro through the Catalan Society of Nephrology; Roche Netherlands, The HDF Pooling project was designed, conducted and analysed independently of the financial contributors of the individual studies as listed below. Study data were collected and retained by the investigators and were not available for the financial contributors of the individual studies. S.A.E.P. and the meetings of the representatives of the combined authors of the four studies were financially supported by the EuDial working group. EuDial is an official working group of the European Renal Association-European Dialysis Transplant Association (ERA-EDTA, http://era-edta.org/eudial/European_Dialysis_Working_Group.html). No industry funding was received for any part of or activity related to the present analysis.; The Turkish HDF study was supported by European Nephrology and Dialysis Institute with an unrestricted grant. The study was performed in Fresenius Medical Care haemodialysis clinics in Turkey. ESHOL was supported by The Catalan Society of Nephrology and by grants from Fresenius Medical Care and Gambro through the Catalan Society of Nephrology. The CONTRAST study was supported by a grant from the Dutch Kidney Foundation (Nierstichting Nederland Grant C02.2019), and unrestricted grants from Fresenius Medical Care, Netherlands, and Gambro Lundia AB, Sweden. Additional support was received from the Dr E.E. Twiss Fund, Roche Netherlands, the International Society of Nephrology/Baxter Extramural Grant Program, and the Netherlands Organization for Health Research and Development (ZONMw Grant 170882802). The French HDF study was supported by a national grant from the Health Ministry (Programme Hospitalier de Recherche Clinique, PHRC) as a means to improve care and outcome of elderly chronic disease patients.

Item does not contain fulltext BACKGROUND AND OBJECTIVES: Inflammation and malnutrition are important features in patients with ESRD; however, data on changes in these parameters over time are scarce. This study aimed to gain insight into changes over time in serum albumin, body mass index, high-sensitivity C-reactive protein, and IL-6 in patients with ESRD and aimed to identify clinical risk factors for deterioration of these parameters. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Data were analyzed from the Convective Transport Study, a randomized controlled trial conducted from June 2004 to January 2011, in which 714 patients with chronic ESRD were randomized to either online hemodiafiltration or low-flux hemodialysis. Albumin and body mass index were measured up to 6 years and predialysis C-reactive protein and IL-6 were measured up to 3 years in a subset of 405 participants. Rates of change in these parameters over time were estimated across strata of predefined risk factors with linear mixed-effects models. RESULTS: Albumin and body mass index decreased and C-reactive protein and IL-6 increased over time. For every incremental year of age at baseline, the yearly excess decline in albumin was 0.003 g/dl (-0.004 to -0.002; P

Most childhood obesity research has classified participants by normative standards for Body Mass Index (BMI) through population percentiles or values corresponding to overweight adults (World Health Organization (WHO), Centers for Disease Control and Prevention (CDC) and the International Obesity Task Force (IOTF)). In 2006, criterion-referenced standards (FitnessGram®) were developed (revised in 2010) which directly associate BMI values with adverse health outcomes. This study assessed agreement between normative and criterion-referenced standards. Participants included 653 Mexican American 3rd to 5th graders living in the U.S.-Mexico border area who participated in a health promotion project. At baseline, agreement was compared between normative and criterion-referenced classifications. At follow-up, agreement between classifications on changes (e.g. from overweight to healthy weight) was assessed. According to FitnessGram® standards, 53.0% of participants were overweight or obese at baseline. Compared to FitnessGram®, the IOTF and CDC standards classified 15% fewer participants as obese/high risk. The WHO standards were closely related to FitnessGram® (kappa=.925) and showed significantly greater agreement with FitnessGram® than the CDC (kappa=.925 versus 0.722, p

Nanodiamond-reinforced aluminum metal matrix composites (ND–Al MMC) powders were synthesized by means of high energy ball milling. We present a systematic study of the effect of various milling conditions on the structure and properties of the resulting MMC powders. The described method can be used to control important powder characteristics, including particle size and shape, Al crystal size and residual strain, and structural integrity and dispersion of the nanoparticle inclusions, a crucial requirement for subsequent powder consolidation. Raman spectroscopy was utilized for the first time to directly verify the structural integrity and the dispersion of ND in the Al matrix. For low ball-to-powder ratios (BPR), average particle size and size range of the ND–Al composite powders were found to decrease during milling, while the hardness increases. A BPR of 10:1, a milling time of 10 h, and a ND content of 10 wt.% were most effective in obtaining small powder particle sizes, small Al crystal sizes, and improved mechanical properties reaching a hardness of 3.46 GPa, a 210% increase over the pristine, untreated Al powder (1.10 GPa). Finally, we demonstrate that the as-produced composite powders are well-suited for low-temperature consolidation processing by fabricating the first cold-sprayed ND–Al MMC coating.

Background/Aims: Guidelines for the management of anemia and iron deficiency in chronic hemodialysis (HD) patients have been developed to standardize therapy and improve clinical outcome. The present study evaluated compliance with anemia guidelines and investigated whether differences between centers were present. Methods: Data on anemia management from patients in the baseline cohort of the CONTRAST study (NCT00205556) were analyzed. 598 chronic HD patients (62% male, age 63.6 ± 14.0 years) from 26 Dutch dialysis centers were included. Results: Mean hemoglobin (Hb) level was 11.9 ± 1.3 g/dl and Hb was ≥11.0 g/dl in 81% of the patients. Compliance with all anemia targets (Hb 11.0–12.0 g/dl, transferrin saturation ratio ≥20%, ferritin 100–500 ng/ml) was reached in 11.6% (95% CI 7.8–17.0) of the patients, with a wide range among centers (4–26%, adjusted for case mix, treatment-related factors and center-specific characteristics). Conclusion: Compliance with anemia targets in stable HD patients was poor and showed a wide variation between treatment facilities.

Extensor carpi ulnaris (ECU) dislocation is a rare injury most often described in young racket and stick athletes. In this report a pole-vault jumper with ECU dislocation Is described. Clinically there was suspicion for ECU pathology and ultrasound (US) confirmed an ECU luxation. The patient was treated with a long arm cast with the forearm in 30 degrees supination and a neutral position of the wrist for 8 weeks. ECU luxation Is described mostly as posttraumatic. Clinically there is pain distalty in the ulnary groove and along the ECU tendon. US and MRI may confirm the diagnosis. Treatment consists of Immobilisation or surgical reconstruction. For both therapies good results are described.