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Schwarz CE, O'Toole JM, Healy DB, Panaviene J, Livingstone V, Dempsey EM. Electrical Cardiometry during transition and short-term outcome in very preterm infants: a prospective observational study. Eur J Pediatr 2024; 183:1629-1636. [PMID: 38189914 PMCID: PMC11001706 DOI: 10.1007/s00431-023-05387-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 01/09/2024]
Abstract
The purpose of this study is to evaluate the association of Electrical Cardiometry (EC)-derived cardiac output indexed to weight (CO) and its changes during the first 48 h in relation to adverse short-term outcome in very preterm infants. In this prospective observational study of preterm infants < 32 weeks gestational age (GA), the combined adverse outcome was defined as mortality or abnormal cranial ultrasound (any grade intracranial hemorrhage (ICH) or periventricular leukomalacia) within the first 2 weeks postnatally. Logistic regression models were used to investigate the association between median CO and outcome and mixed-effects models for the time trajectory of CO. In the absence of device-specific thresholds for low or high CO, no thresholds were used in our analysis. Fifty-three infants (median (IQR) GA 29.0 (25.4-30.6) weeks, birthweight 1020 (745-1505) g) were included in the analysis. Median CO was 241 (197-275) mL/kg/min for the adverse outcome and 198 (175-227) mL/kg/min for normal outcome (odds ratio (OR) (95% confidence interval (95% CI)), 1.01 (1.00 to 1.03); p = 0.028). After adjustment for GA, the difference was not significant (adjusted OR (95% CI), 1.01 (0.99 to 1.02); p = 0.373). CO trajectory did not differ by outcome (p = 0.352). A post hoc analysis revealed an association between CO time trajectory and ICH ≥ grade 2. Conclusions: EC-derived CO estimates within 48 h postnatally were not independently associated with brain injury (any grade) or mortality in the first 14 days of life. CO time trajectory was found to be associated with ICH ≥ grade 2. What is Known: • Bioreactance-derived cardiac output indexed to bodyweight (CO) in the transitional period has been associated with adverse short-term outcome in preterm infants. What is New: • Electrical Cardiometry (EC)-derived CO measurements in very preterm infants during the transitional period are not independently associated with adverse outcome (death or ultrasound detected brain damage) within 2 weeks postnatally. • In the first 48 h EC-derived CO increases over time and is higher in extremely preterm infants compared to very preterm and differs from previously reported bioreactance-derived CO values.
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Affiliation(s)
- C E Schwarz
- Department of Paediatrics & Child Health, University College Cork, Cork, Ireland.
- INFANT Research Centre, University College Cork, Cork, Ireland.
- Department of Neonatology, Center for Pediatric and Adolescent Medicine, University of Heidelberg, Im Neuenheimer Feld 430, 69120, Heidelberg, Germany.
| | - J M O'Toole
- Department of Paediatrics & Child Health, University College Cork, Cork, Ireland
- INFANT Research Centre, University College Cork, Cork, Ireland
| | - D B Healy
- Department of Paediatrics & Child Health, University College Cork, Cork, Ireland
| | - J Panaviene
- Department of Paediatrics & Child Health, University College Cork, Cork, Ireland
- INFANT Research Centre, University College Cork, Cork, Ireland
| | - V Livingstone
- Department of Paediatrics & Child Health, University College Cork, Cork, Ireland
- INFANT Research Centre, University College Cork, Cork, Ireland
| | - E M Dempsey
- Department of Paediatrics & Child Health, University College Cork, Cork, Ireland
- INFANT Research Centre, University College Cork, Cork, Ireland
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Gatti S, Rezoagli E, Madotto F, Foti G, Bellani G. A non-invasive continuous and real-time volumetric monitoring in spontaneous breathing subjects based on bioimpedance-ExSpiron®Xi: a validation study in healthy volunteers. J Clin Monit Comput 2024; 38:539-551. [PMID: 38238635 PMCID: PMC10994998 DOI: 10.1007/s10877-023-01107-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 11/10/2023] [Indexed: 04/06/2024]
Abstract
Tidal volume (TV) monitoring breath-by-breath is not available at bedside in non-intubated patients. However, TV monitoring may be useful to evaluate the work of breathing. A non-invasive device based on bioimpedance provides continuous and real-time volumetric tidal estimation during spontaneous breathing. We performed a prospective study in healthy volunteers aimed at evaluating the accuracy, the precision and the trending ability of measurements of ExSpiron®Xi as compared with the gold standard (i.e. spirometry). Further, we explored whether the differences between the 2 devices would be improved by the calibration of ExSpiron®Xi with a pre-determined tidal volume. Analysis accounted for the repeated nature of measurements within each subject. We enrolled 13 healthy volunteers, including 5 men and 8 women. Tidal volume, TV/ideal body weight (IBW) and respiratory rate (RR) measured with spirometer (TVSpirometer) and with ExSpiron®Xi (TVExSpiron) showed a robust correlation, while minute ventilation (MV) showed a weak correlation, in both non/calibrated and calibrated steps. The analysis of the agreement showed that non-calibrated TVExSpiron underestimated TVspirometer, while in the calibrated steps, TVExSpiron overestimated TVspirometer. The calibration procedure did not reduce the average absolute difference (error) between TVSpirometer and TVExSpiron. This happened similarly for TV/IBW and MV, while RR showed high accuracy and precision. The trending ability was excellent for TV, TV/IBW and RR. The concordance rate (CR) was >95% in both calibrated and non-calibrated measurements. The trending ability of minute ventilation was limited. Absolute error for both calibrated and not calibrated values of TV, TV/IBW and MV accounting for repeated measurements was variably associated with BMI, height and smoking status. Conclusions: Non-invasive TV, TV/IBW and RR estimation by ExSpiron®Xi was strongly correlated with tidal ventilation according to the gold standard spirometer technique. This data was not confirmed for MV. The calibration of the device did not improve its performance. Although the accuracy of ExSpiron®Xi was mild and the precision was limited for TV, TV/IBW and MV, the trending ability of the device was strong specifically for TV, TV/IBW and RR. This makes ExSpiron®Xi a non-invasive monitoring system that may detect real-time tidal volume ventilation changes and then suggest the need to better optimize the patient ventilatory support.
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Affiliation(s)
- Stefano Gatti
- Department of Emergency and Intensive Care, Terapia Intensiva e Semintensiva adulti e Pediatrica, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Emanuele Rezoagli
- Department of Emergency and Intensive Care, Terapia Intensiva e Semintensiva adulti e Pediatrica, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Fabiana Madotto
- Department of Area Emergenza Urgenza, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Foti
- Department of Emergency and Intensive Care, Terapia Intensiva e Semintensiva adulti e Pediatrica, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Giacomo Bellani
- Centre for Medical Sciences - CISMed, University of Trento, Trento, Italy.
- Anesthesia and Intensive Care, Santa Chiara Regional Hospital, APSS Trento Largo Medaglie d'Oro, Trento, Italy.
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Whitworth P, Vicini F, Valente SA, Brownson K, DuPree B, Kohli M, Lawson L, Shah C. Reducing rates of chronic breast cancer-related lymphedema with screening and early intervention: an update of recent data. J Cancer Surviv 2024; 18:344-351. [PMID: 35947288 DOI: 10.1007/s11764-022-01242-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 07/23/2022] [Indexed: 10/15/2022]
Abstract
PURPOSE Breast cancer-related lymphedema (BCRL) represents a dreaded complication of breast cancer treatment that can lead to morbidity, diminished quality of life, and psychosocial harm and is associated with increased costs of care. Increasingly, data has supported the concept of prospective BCRL surveillance coupled with early intervention to mitigate these effects. METHODS We performed a systematic review of the literature searching for published randomized and prospective data evaluating prospective BCRL surveillance with early intervention. RESULTS We identified 12 studies (2907 patients) including 4 randomized trials (1203 patients) and 8 prospective studies (1704 patients). Randomized data consistently demonstrate that early intervention reduces rates of progression to chronic BCRL with multiple paradigms and diagnostic modalities utilized; the strongest data comes from the randomized PREVENT trial, which demonstrated early detection with bioimpedance spectroscopy (BIS), coupled with early intervention with a compression garment applied for 12 h a day over 4 weeks, significantly reduced the rate of chronic BCRL compared to tape measurement coupled with early intervention. CONCLUSIONS Current data support the role of prospective BCRL surveillance with early detection and intervention to reduce rates of chronic BCRL. Breast cancer patients at risk for BCRL should undergo prospective surveillance as part of survivorship. Because level 1 data demonstrate that BIS is superior to conventional tape measure, it should be included as the standard BCRL diagnostic modality unless an equally effective modality is employed. IMPLICATIONS FOR CANCER SURVIVORS Breast cancer survivor should undergo prospective BCRL screening with BIS.
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Affiliation(s)
| | - Frank Vicini
- Michigan Healthcare Professionals, Farmington Hills, MI, USA
| | - Stephanie A Valente
- Department of Breast Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Kirstyn Brownson
- Department of General Surgery, University of Utah, Salt Lake City, UT, USA
| | | | - Manpreet Kohli
- Department of General Surgery, RWJ Barnabas Health, West Long Beach, NJ, USA
| | | | - Chirag Shah
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
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4
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Hansen SS, Munk T, Knudsen AW, Beck AM. Concordance between changes in calf circumference and muscle mass exists: A narrative literature review. Clin Nutr ESPEN 2024; 59:171-175. [PMID: 38220372 DOI: 10.1016/j.clnesp.2023.11.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 11/09/2023] [Accepted: 11/30/2023] [Indexed: 01/16/2024]
Abstract
Technological methods such as BIA or DXA are not always accessible in clinical practice, thus GLIM supports the use of calf circumference measurements to examine muscle mass. However, it has not been described if measurements of calf circumference can detect a change in muscle mass to the same degree as the technological methods. The aim of this study was to assess, whether changes in calf circumference can be used as a valid proxy for changes in muscle mass. 10 studies including measurements of muscle mass by calf circumference and technological methods at baseline and follow-up were identified through a narrative literature review. Results were used to determine concordance between measurements. Predominantly concordance between changes in calf circumference and muscle mass assessed by BIA or DXA was reviled. However, the results were not uniform for hospitalized patients or older adults as groups. Thus, uncertainty whether changes in calf circumference can be used as a valid proxy for changes in muscle mass in these groups still exist.
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Affiliation(s)
- Signe Skovgaard Hansen
- The Unit for Dieticians and Nutrition Research, EATEN, Herlev and Gentofte Hospital, Borgmester Ib Juuls vej 1, Denmark.
| | - Tina Munk
- The Unit for Dieticians and Nutrition Research, EATEN, Herlev and Gentofte Hospital, Borgmester Ib Juuls vej 1, Denmark.
| | - Anne Wilkens Knudsen
- The Unit for Dieticians and Nutrition Research, EATEN, Herlev and Gentofte Hospital, Borgmester Ib Juuls vej 1, Denmark.
| | - Anne Marie Beck
- The Unit for Dieticians and Nutrition Research, EATEN, Herlev and Gentofte Hospital, Borgmester Ib Juuls vej 1, Denmark.
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Hübl N, Riebold B, Schramm D, Seidl RO. Differences in the swallowing process of newborns and healthy preterm infants: first results with a non-invasive bioimpedance and electromyography measurement system. Eur Arch Otorhinolaryngol 2024; 281:843-854. [PMID: 37996534 PMCID: PMC10796423 DOI: 10.1007/s00405-023-08344-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 11/06/2023] [Indexed: 11/25/2023]
Abstract
PURPOSE Preterm infants (PI) have difficulty coordinating sucking, swallowing and breathing, and there is a risk of aspiration. The causes of this are not yet sufficiently understood. The aim of this study was to test a novel measurement device to measure breathing and pharyngeal processes involved in swallowing externally in everyday life to identify possible differences in neonates (NB) and PI. METHODS Forty healthy NB were studied at 4-8 weeks of age (mean: 6.7 weeks) and 20 healthy PI (mean gestational age 30.5 weeks) at postmenstrual age (PMA) 34/35 weeks (mean PMA 35.1 weeks) during a single feeding. Surface electrodes were used to measure bioimpedance and electromyography reflecting swallow-related changes in the pharynx and muscle activation of the tongue and submental muscles. A respiratory belt was combined with recording of the depth of chest movements and the occurrence of pauses in breathing. RESULTS Velocity and extent of pharyngeal closure did not differ significantly across the feeding period (velocity: p=0.09, closure: p=0.17), but during the first two suck-swallow bursts PI had greater velocity (p<0.001*) and extent of pharyngeal closure (p=0.004*) than NB. The duration of swallowing phases was significantly longer in PIs (p<0.001*), their muscle activation decreased faster (p<0.001*), and they had more pauses in breathing than NBs. CONCLUSIONS The novel measurement device allowed, for the first time in everyday life, the measurement of factors influencing swallowing and breath-swallow coordination in NBs and PIs. PIs showed differences from NBs most likely due to differences in muscle strength and condition.
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Affiliation(s)
- Nicole Hübl
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Germany, Moorenstrasse 5, 40225, Düsseldorf, Germany.
| | - Benjamin Riebold
- TU Berlin, Control Systems Group, Einsteinufer 17, 10587, Berlin, Germany
| | - Dirk Schramm
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Germany, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Rainer O Seidl
- Ear-Nose and Throat, Unfallkrankenhaus Berlin, UKB, Warener Str.7, 12683, Berlin, Germany
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Pellicori P, Cleland JGF, Borentain M, Taubel J, Graham FJ, Khan J, Bruzzese D, Kessler P, McMurray JJV, Voors AA, O'Connor CM, Teerlink JR, Felker GM. Impact of vasodilators on diuretic response in patients with congestive heart failure: A mechanistic trial of cimlanod (BMS-986231). Eur J Heart Fail 2024; 26:142-151. [PMID: 37990754 DOI: 10.1002/ejhf.3077] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/04/2023] [Accepted: 10/24/2023] [Indexed: 11/23/2023] Open
Abstract
AIM To investigate the effects of Cimlanod, a nitroxyl donor with vasodilator properties, on water and salt excretion after an administration of an intravenos bolus of furosemide. METHODS AND RESULTS In this randomized, double-blind, mechanistic, crossover trial, 21 patients with left ventricular ejection fraction <45%, increased plasma concentrations of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and receiving loop diuretics were given, on separate study days, either an 8 h intravenous (IV) infusion of cimlanod (12 μg/kg/min) or placebo. Furosemide was given as a 40 mg IV bolus four hours after the start of infusion. The primary endpoint was urine volume in the 4 h after the bolus of furosemide during infusion of cimlanod compared with placebo. Median NT-proBNP at baseline was 1487 (interquartile range: 847-2665) ng/L. Infusion of cimlanod increased cardiac output and reduced blood pressure without affecting cardiac power index consistent with its vasodilator effects. Urine volume in the 4 h post-furosemide was lower with cimlanod (1032 ± 393 ml) versus placebo (1481 ± 560 ml) (p = 0.002), as were total sodium excretion (p = 0.004), fractional sodium excretion (p = 0.016), systolic blood pressure (p < 0.001), estimated glomerular filtration rate (p = 0.012), and haemoglobin (p = 0.010), an index of plasma volume expansion. CONCLUSIONS For patients with heart failure and congestion, vasodilatation with agents such as cimlanod reduces the response to diuretic agents, which may offset any benefit from acute reductions in cardiac preload and afterload.
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Affiliation(s)
- Pierpaolo Pellicori
- British Heart Foundation Cardiovascular Research Centre, School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow, UK
| | - John G F Cleland
- British Heart Foundation Cardiovascular Research Centre, School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow, UK
| | | | - Jorg Taubel
- Richmond Pharmacology Ltd, St. George's University of London, London, UK
| | - Fraser J Graham
- British Heart Foundation Cardiovascular Research Centre, School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow, UK
| | - Javed Khan
- British Heart Foundation Cardiovascular Research Centre, School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow, UK
| | - Dario Bruzzese
- Department of Public Health, University of Naples 'Federico II', Naples, Italy
| | | | - John J V McMurray
- British Heart Foundation Cardiovascular Research Centre, School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow, UK
| | - Adriaan A Voors
- University of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands
| | | | - John R Teerlink
- Section of Cardiology, San Francisco Veterans Affairs Medical Center and School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - G Michael Felker
- Duke University School of Medicine and the Duke Clinical Research Institute, Durham, NC, USA
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Kawaguchi Y, Hanafusa N, Sakurai S, Miyaji M, Toda N, Iwadoh K, Tsuchiya K. The uric acid-urea distribution volume ratio is a potential marker of hydration status in patients on hemodialysis. J Artif Organs 2023; 26:316-325. [PMID: 36565326 DOI: 10.1007/s10047-022-01377-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 11/30/2022] [Indexed: 12/25/2022]
Abstract
The distribution volume of uric acid is affected by the amount of extracellular water (ECW), while urea distribution volume can be considered as total body water (TBW). Thus, the ratio of distribution volumes of uric acid and urea can be paralleled to and be considered as the proxy of ECW/TBW. A total of 108 patients at our facility was included. The uric acid and urea distribution volume ratio (UUVdR) calculated from the single-pool model, which was measured within 1 month of the time when the bioimpedance index was measured. ECW/TBW at the end of the HD session was measured by InBody S10. We investigated the association between the UUVdR and the ECW/TBW values and the factors affecting the residuals of the regression equation. We also evaluated the predictive ability of overhydration or dehydration in randomly selected two groups, i.e., the training group and the validation group. ECW/TBW correlated highly with UUVdR. Multivariate analysis demonstrated that only creatinine and ECW/TBW were significantly associated with regression residuals. The cutoff values of UUVdR for overhydration and dehydration were 0.666 and 0.579, respectively, in the training group. Their AUC were 0.872 and 0.898, respectively. The sensitivity and specificity values in the validation group were 0.571 and 0.868 for overhydration, and 0.444 and 0.953 for dehydration, respectively. UUVdR might be a proxy of hydration status in hemodialysis patients. It may be possible to predict hydration status without dedicated devices in the epidemiological study.
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Affiliation(s)
- Yuki Kawaguchi
- Department of Blood Purification, Tokyo Women's Medical University, 8-1, Kawada-Cho, Shinjuku-Ku, Tokyo, 162-8666, Japan.
| | - Norio Hanafusa
- Department of Blood Purification, Tokyo Women's Medical University, 8-1, Kawada-Cho, Shinjuku-Ku, Tokyo, 162-8666, Japan.
| | - Satoko Sakurai
- Department of Blood Purification, Tokyo Women's Medical University, 8-1, Kawada-Cho, Shinjuku-Ku, Tokyo, 162-8666, Japan
| | - Mai Miyaji
- Department of Blood Purification, Tokyo Women's Medical University, 8-1, Kawada-Cho, Shinjuku-Ku, Tokyo, 162-8666, Japan
| | - Naohiro Toda
- Department of Blood Purification, Tokyo Women's Medical University, 8-1, Kawada-Cho, Shinjuku-Ku, Tokyo, 162-8666, Japan
| | - Kazuhiro Iwadoh
- Department of Blood Purification, Tokyo Women's Medical University, 8-1, Kawada-Cho, Shinjuku-Ku, Tokyo, 162-8666, Japan
| | - Ken Tsuchiya
- Department of Blood Purification, Tokyo Women's Medical University, 8-1, Kawada-Cho, Shinjuku-Ku, Tokyo, 162-8666, Japan
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Escobar Fernández J, Martínez López C, Mosquera Leyton V. A low-cost, portable 32-channel EIT system with four rings based on AFE4300 for body composition analysis. HardwareX 2023; 16:e00494. [PMID: 38186666 PMCID: PMC10767629 DOI: 10.1016/j.ohx.2023.e00494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/19/2023] [Accepted: 11/11/2023] [Indexed: 01/09/2024]
Abstract
A proposed low-cost, portable, 32-channel (4 rings of 8-channel) Electrical Impedance Tomography (EIT) system based on the AFE4300 analog front-end for body composition measurement. Each ring allows obtaining the conductivity distribution of 4 cross sections, 4 cm apart; to analyze the behavior of conductivity in a volume. The switching of the 4 rings and the current injection and voltage measurement patterns are done with three Texas Instruments 74HC4067 multiplexers, which are managed by an ESP32 board. The proposed system has an average signal-to-noise ratio of 74.71 dB and a frame rate of 50 fps. The sensitivity tests to impedance and volume changes consisted of introducing 4 tubes of different diameters (2 steel and 2 polyvinyl chloride) into a tank with saline solution; then conductivity distribution images were generated in 4 cross-sections of the tank, using the algorithms Gauss-Newton and Noser. Finally, the global impedance index (GI) is calculated to estimate the volume of each tube inside the tank. The results show that the proposed system is highly sensitive to impedance and volume changes, being a promising system for monitoring tissues, and fluids biological.
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Affiliation(s)
| | | | - Víctor Mosquera Leyton
- Universidad del Cauca, Electronic, Instrumentation, and Control Department, Street 5 No 4-70, Popayán, Colombia
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Dou Y, Li A, Liu G, Wang P, Zhang B. Comparison of bioimpedance equations and dual-energy X-ray for assessment of fat free mass in a Chinese dialysis population. Ren Fail 2023; 45:2182131. [PMID: 36856322 PMCID: PMC10108741 DOI: 10.1080/0886022x.2023.2182131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
PURPOSE Bioelectrical impedance analysis (BIA) is simple, noninvasive, inexpensive and frequently used for estimating fat free mass (FFM). The aims of this study were to evaluate the applicability of different BIA equations on FFM in Chinese subjects, and to compare the difference in hemodialysis and peritoneal dialysis patients with healthy controls respectively. METHODS Dialysis patients and healthy adults were enrolled in this study, and the subjects were matched by age, gender, and the minimum sample size in each group was calculated using PASS. FFM estimated by BIA was calculated using equations of Kyle, Sun SS and Segal, and TBW/0.73. Dual-energy X-ray absorptiometry (DXA) method was set as reference method. Pearson's correlation and Bland-Altman analysis were used to test the validity of the BIA equations. RESULTS 50 hemodialysis (HD) patients, 52 peritoneal dialysis (PD) patients and 30 healthy adults aged 22-67 y were included in this study. Age, height, weight, BMI and gender did not differ significantly among HD, PD patients, and healthy controls (p > 0.05), but BIA parameters were quite different (p<0.01). Bland-Altman analysis showed that in healthy volunteers, all equations showed good agreement with DXA measured. For dialysis patients, the FFM predictions of different equations showed differences between HD and PD patients, and the equations seemed more applicable for HD patients. CONCLUSION The equations developed by healthy subjects might be not appropriate for dialysis patients, especially peritoneal dialysis patients. It is recommended to develop a specific BIA equation from dialysis population.
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Affiliation(s)
- Yanna Dou
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Afang Li
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Gangrong Liu
- Department of Bone Mineral Density, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Peipei Wang
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Bei Zhang
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Silva LCDA, Correia MDA, Gouveia RD, Souza MS, Junior CIP, Parrillo F, Moysés RMA, Dalboni MA, Elias RM. Effects of nutritional supplementation stabilizing muscle mass loss in older patients on hemodiafiltration. Clin Nutr ESPEN 2023; 58:97-103. [PMID: 38057042 DOI: 10.1016/j.clnesp.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/24/2023] [Accepted: 09/07/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND & AIMS Malnutrition is common in older individuals with end-stage renal disease on maintenance dialysis. Whether nutritional supplementation may improve skeletal muscle mass (SMM) and survival rate in this population is uncertain. We aimed to analyze the effect of a year of nutritional supplementation on muscle mass and survival rate in older patients on hemodiafiltration. METHODS In this observational study, older patients (≥65 years old) on maintenance hemodiafiltration were selected to receive nutritional counselling + nutritional supplementation (N = 85, Supp+) or nutritional counselling alone (N = 47, Supp-) and followed for 1 year. The outcomes were a change in SMM and sarcopenia diagnosis. The secondary outcome was 1-year mortality rate. Nutritional parameters included calf circumference, body mass index, anthropometric measurements, subjective global assessment, and handgrip strength (HGS). Data were evaluated using GLM for repeated measures with adjustment for covariates (age and diabetes). RESULTS Malnutrition was found in 50.8% of patients. At baseline, patients from the Supp+ group were older and had worse nutritional parameters including hand grip strength, calf circumference, anthropometric findings and sarcopenia (all p values < 0.05). During the follow-up, there was no significant change in sarcopenia (from 50.8% to 58.3%, p = 0.108), and there was a more pronounced decrease in the SMM index in the Supp-group (p = 0.049), with a significant intervention interaction (p = 0.030). Twenty deaths occurred, 7 (35%) in the Supp- and 13 (65%) in the Supp+ group (p = 0.540). SMM index (relative risk 0.90, p = 0.030) and age (relative risk 1.07, p = 0.046) were independently associated with higher mortality rates. CONCLUSION Nutritional supplementation in older and malnourished individuals undergoing hemodiafiltration mitigates the loss of the SMM index and benefits survival rate.
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Affiliation(s)
- Luana Cristina de A Silva
- Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil; Hospital Sancta Maggiore, São Paulo, SP, Brazil
| | | | | | | | | | | | - Rosa M A Moysés
- Hospital das Clinicas HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | - Rosilene M Elias
- Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil; Hospital das Clinicas HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil.
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11
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Hlubik J, Vyslouzilova L, Studnicka F, Vychodil R, Lhotska L. A Pilot Study to Assess Hydration in Geriatric Patients by Bioimpedance. Stud Health Technol Inform 2023; 309:250-254. [PMID: 37869852 DOI: 10.3233/shti230790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
Hydration plays a very important role in old age. This is because hydration changes over the course of life and therefore geriatric patients need to have their hydration monitored. However, the general problem is that there are no completely reliable methods' that can measure this. In this paper we performed a pilot monitoring in geriatric patients and compared directly measured electrical data with results from biochemistry. The observed correlations on our pilot sample show very promising values for (r=0.68) creatinine correlation with phase angle and (r=0.71) creatinine correlation with NI (nutritional index). It also shows that electrical readings may in the future indicate much more accurately the true status of the patient. Our research is still ongoing, and we are planning further measurements on a larger sample.
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Affiliation(s)
- Jan Hlubik
- CTU in Prague, Czech Institute of Informatics, Robotics and Cybernetics, Cognitive Systems and Neurosciences, Czech Republic
| | - Lenka Vyslouzilova
- CTU in Prague, Czech Institute of Informatics, Robotics and Cybernetics, Cognitive Systems and Neurosciences, Czech Republic
| | - Filip Studnicka
- University of Hradec Králové, Faculty of Science, Department of Physics, Czech Republic
| | - Rostislav Vychodil
- CTU in Prague, Czech Institute of Informatics, Robotics and Cybernetics, Cognitive Systems and Neurosciences, Czech Republic
| | - Lenka Lhotska
- CTU in Prague, Czech Institute of Informatics, Robotics and Cybernetics, Cognitive Systems and Neurosciences, Czech Republic
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Mussnig S, Schmiedecker M, Waller M, Niknam J, Paschen C, Schneditz D, Hecking M, Krenn S. Differences in bioimpedance-derived fluid status between two versions of the Body Composition Monitor. Nutrition 2023; 114:112131. [PMID: 37467529 DOI: 10.1016/j.nut.2023.112131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/08/2023] [Accepted: 06/10/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVES The Body Composition Monitor (BCM) (Fresenius Medical Care) measures body impedances in alternating currents to subsequently calculate fat and lean tissue mass, fluid compartments, and overhydration (OH). The aim of this study was to investigate differences between two versions of the BCM (an older version, 3.2.5, and a newer version, 3.3.3). METHODS Between September 2021 and December 2021, 28 hemodialysis patients were included to undergo BCM measurements before each of 14 consecutive dialysis sessions with versions 3.2.5 and 3.3.3 devices. Measurements were performed according to instructions provided by the manufacturer. Differences between BCM devices were tested for statistical significance using paired Wilcoxon tests, neglecting clustering. RESULTS A total of 288 measurement pairs of 27 patients were left after exclusion of 43 flawed data points. The mean difference in OH between both BCM devices was 0.548 L (higher for version 3.2.5). Analysis of impedance data revealed differences in the high-frequency spectrum, quantifiable by the intracellular resistance, Ri (median Ri version 3.2.5 = 1750.3 Ω; Ri version 3.3.3 = 1612.45 Ω; P < 0.001), and the time delay, Td (median Td version 3.2.5 = 1.85 ns; Td version 3.3.3 = 8.88 nanoseconds; P < 0.001). CONCLUSIONS This study finds that results between the two versions of the BCM differed in a clinically meaningful fashion and that the newer version 3.3.3 device had a bias toward less OH. Circulating BCM devices should be checked for versions and only devices of the same version should be used for each patient to ensure better within-patient consistency.
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Affiliation(s)
- Sebastian Mussnig
- Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Michael Schmiedecker
- Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Maximilian Waller
- Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria; Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Janosch Niknam
- Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Christopher Paschen
- Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Daniel Schneditz
- Division of Physiology and Pathophysiology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Graz, Austria
| | - Manfred Hecking
- Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria; Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria.
| | - Simon Krenn
- Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria; Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria; Medical Signal Analysis, Center for Health & Bioresources, AIT Austrian Institute of Technology, Vienna, Austria
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13
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Muramae N, Matsuda T, Inagaki S, Takahashi H, Abe K, Nakatani S, Takahashi M, Kato K, Sakaguchi K, Ogawa W. Determinants of phase angle in Japanese patients with diabetes. Diabetol Int 2023; 14:339-343. [PMID: 37781466 PMCID: PMC10533457 DOI: 10.1007/s13340-023-00633-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 05/08/2023] [Indexed: 10/03/2023]
Abstract
Phase angle, obtained using bioelectrical impedance analysis, non-invasively reflects the whole-body cellular condition and nutritional status and may be helpful as a prognostic factor. Patients with diabetes had a smaller phase angle than healthy subjects. However, the clinical significance of phase angle has not yet been elucidated. Therefore, the purpose of this study was to clarify the relationship between phase angle and HbA1c in patients with diabetes and the clinical relevance of phase angle. A retrospective, multicenter, cross-sectional study was conducted with Japanese patients with diabetes. Body composition was determined with bioelectrical impedance analysis, and this was used to obtain phase angle. Phase angle was assessed in relation to clinical parameters, body composition parameters, and HbA1c levels. A total of 655 patients were enrolled (400 men and 255 women, aged 57.1 ± 14.8 years, body mass index 25.6 ± 5.2 kg/m2, HbA1c 8.1 ± 1.9%). Even in patients with diabetes, the phase angle was higher in men than in women and did not differ between the types of diabetes. Multiple regression analysis, performed with phase angle as the objective variable, and age, sex, diabetes type, HbA1c, albumin level, and body mass index as explanatory variables, revealed that phase angle was negatively affected by HbA1c (B = - 0.043, 95% Confidence interval: - 0.07 to - 0.02, p < 0.001). HbA1c, age, sex, albumin level, and body mass index were independent determinants of phase angle in participants with diabetes.
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Affiliation(s)
- Naokazu Muramae
- Department of General Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan
- Department of Diabetes and Endocrinology, Kobe University Graduate School of Medicine, Kobe, Japan
| | | | - Satoshi Inagaki
- School of Nursing, Kobe City College of Nursing, Kobe, Japan
| | | | - Kozue Abe
- Matsuda Diabetes Clinic, Kobe, Japan
| | - Saki Nakatani
- Department of Nutrition, Kobe University Hospital, Kobe, Japan
| | | | - Kenji Kato
- Faculty of Nursing Science, Kobe Women’s University, Kobe, Japan
| | - Kazuhiko Sakaguchi
- Department of General Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan
- Department of Diabetes and Endocrinology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Wataru Ogawa
- Department of Diabetes and Endocrinology, Kobe University Graduate School of Medicine, Kobe, Japan
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14
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Ukai T, Watanabe M. Do metal implants for total hip arthroplasty affect bioelectrical impedance analysis? A retrospective study. BMC Musculoskelet Disord 2023; 24:763. [PMID: 37759188 PMCID: PMC10538019 DOI: 10.1186/s12891-023-06893-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Evaluation of body composition after total hip arthroplasty (THA) is essential because it can be used to evaluate muscle and functional recovery. Muscle volume and degeneration are evaluated using computed tomography (CT). However, CT evaluation of muscle volume has several limitations, such as radiation exposure and high medical cost. Bioelectrical impedance analysis (BIA) has gained attention for resolving these limitations of CT. BIA takes advantage of the microelectric current; thus, metal implants may affect the results. Therefore, this study aimed to elucidate the effects of metal implants on BIA after THA. METHODS Two groups of patients were assessed (Group 1: 70 patients who underwent unilateral THA and BIA; Group 2: 35 patients who underwent THA and BIA before and after THA). Electric impedance (resistance and reactance) of the operated and non-operated lower limbs was compared in Group 1. The pre- and post-operative impedances of the torso and operated ipsilateral limbs were compared in Group 2. RESULTS Regarding electric impedance in Group 1, no significant differences were observed in electrical resistance and reactance between the operated and non-operated lower limbs. Concerning electric impedance in Group 2, postoperative electric resistance of the torso was significantly lower than that preoperatively. However, no significant difference was seen in electric resistance and reactance of the operated ipsilateral limbs preoperatively and postoperatively. CONCLUSIONS Electrical resistance and reactance of the limbs did not change significantly after THA. BIA is useful for measuring body composition after THA.
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Affiliation(s)
- Taku Ukai
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, 259-1193, Kanagawa, Japan.
| | - Masahiko Watanabe
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, 259-1193, Kanagawa, Japan
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15
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Siedler MR, Rodriguez C, Stratton MT, Harty PS, Keith DS, Green JJ, Boykin JR, White SJ, Williams AD, DeHaven B, Tinsley GM. Assessing the reliability and cross-sectional and longitudinal validity of fifteen bioelectrical impedance analysis devices. Br J Nutr 2023; 130:827-840. [PMID: 36404739 PMCID: PMC10404482 DOI: 10.1017/s0007114522003749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 11/02/2022] [Accepted: 11/15/2022] [Indexed: 11/22/2022]
Abstract
The purpose of this investigation was to expand upon the limited existing research examining the test-retest reliability, cross-sectional validity and longitudinal validity of a sample of bioelectrical impedance analysis (BIA) devices as compared with a laboratory four-compartment (4C) model. Seventy-three healthy participants aged 19-50 years were assessed by each of fifteen BIA devices, with resulting body fat percentage estimates compared with a 4C model utilising air displacement plethysmography, dual-energy X-ray absorptiometry and bioimpedance spectroscopy. A subset of thirty-seven participants returned for a second visit 12-16 weeks later and were included in an analysis of longitudinal validity. The sample of devices included fourteen consumer-grade and one research-grade model in a variety of configurations: hand-to-hand, foot-to-foot and bilateral hand-to-foot (octapolar). BIA devices demonstrated high reliability, with precision error ranging from 0·0 to 0·49 %. Cross-sectional validity varied, with constant error relative to the 4C model ranging from -3·5 (sd 4·1) % to 11·7 (sd 4·7) %, standard error of the estimate values of 3·1-7·5 % and Lin's concordance correlation coefficients (CCC) of 0·48-0·94. For longitudinal validity, constant error ranged from -0·4 (sd 2·1) % to 1·3 (sd 2·7) %, with standard error of the estimate values of 1·7-2·6 % and Lin's CCC of 0·37-0·78. While performance varied widely across the sample investigated, select models of BIA devices (particularly octapolar and select foot-to-foot devices) may hold potential utility for the tracking of body composition over time, particularly in contexts in which the purchase or use of a research-grade device is infeasible.
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Affiliation(s)
- Madelin R. Siedler
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Christian Rodriguez
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Matthew T. Stratton
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Patrick S. Harty
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Dale S. Keith
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Jacob J. Green
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Jake R. Boykin
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Sarah J. White
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Abegale D. Williams
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Brielle DeHaven
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Grant M. Tinsley
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
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Huang WC, Chen YY, Yang SY, Lai CF, Lai TS, Chen HY, Chen L, Wang YJ, Cheng YL, Lang CL, Chen CF, Chang HF, Peng JK, Lin LY, Cheng HM, Hwu CM, Lu TM, Chueh JS, Lin YH, Wu VC. Fat mass as an important predictor of persistent hypertension in patients with primary aldosteronism after adrenalectomy. Hypertens Res 2023; 46:1375-1384. [PMID: 36759661 DOI: 10.1038/s41440-023-01203-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 02/11/2023]
Abstract
Aldosterone excess is present in obesity and is associated with involvement in the pathogenesis of obesity. We evaluate the impact of body obesity as measured by body composition monitor (BCM) on clinical outcomes in patients with unilateral primary aldosteronism (uPA) after adrenalectomy. The BCM device was used to assess body composition before and after adrenalectomy. We used fat mass (FM) and body mass index (BMI) to classify obesity and divided obesity into three groups: clinical overweight (BMI (kg/m2) ≥25); normal weight obesity (NWO, FM (%) ≥ 35 for women, >25 for men & BMI < 25); and no obesity (FM < 35 for women, <25 for men & BMI < 25). A total of 130 unilateral PA (uPA) patients received adrenalectomy, and 27 EH patients were identified; uPA patients with hypertension remission were found to have lower FM (p = 0.046), BMI (p < 0.001), and lower prevalence of overweight (p = 0.001). In the logistic regression model, patients with clinical overweight (OR = 2.9, p = 0.007), NWO (OR = 3.04, p = 0.041) and longer HTN duration (years, OR = 1.065, p = 0.013) were at the risk of persistent hypertension after adrenalectomy. Obesity status was strongly associated with persistent hypertension in uPA patients after adrenalectomy. However, patients in the NWO group also carried higher risk of persistent hypertension. Therefore, assessment of pre-obesity and overweight in uPA patients are extremely important, especially in those who have normal BMI.
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Affiliation(s)
- Wei-Chieh Huang
- Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Cardiology Department of Internal Medicine New Taipei City Hospital, New Taipei City, Taiwan
| | - Ying-Ying Chen
- Division of Nephrology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, Mackay Medical College, New Taipei, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Shao-Yu Yang
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chun-Fu Lai
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Tai-Shuan Lai
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Hsiang-Yao Chen
- Department of Internal Medicine, Taipei Hospital, Ministry of Health and Welfare, Taipei, Taiwan
| | - LiWei Chen
- Division of Cardiology Department of Internal Medicine New Taipei City Hospital, New Taipei City, Taiwan
| | - Yi-Jen Wang
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Yu-Lun Cheng
- Division of Cardiology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Cheng-Lin Lang
- Department of Internal Medicine, Yonghe Cardinal Tien Hospital, New Taipei City, Taiwan
| | - Chih-Fan Chen
- Division of Endocrinology, Department of Internal Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan
| | - Hui-Fang Chang
- Division of Endocrinology, Department of Internal Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan
| | - Jen-Kuei Peng
- Department of Family Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Liang-Yu Lin
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hao-Min Cheng
- Center for Evidence-based Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Ph.D. Program of Interdisciplinary Medicine (PIM), National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan
- Institute of Public Health, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan
- Institute of Health and Welfare Policy, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan
| | - Chii-Min Hwu
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tse-Min Lu
- Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jeff S Chueh
- Department of Urology, National Taiwan University Hospital, Taipei, Taiwan
- Primary Aldosteronism Center, National Taiwan University Hospital, (NTUH-PAC), Taipei, Taiwan
- TAIPAI, Taiwan Primary Aldosteronism Investigation (TAIPAI) Study Group, Taipei, Taiwan
| | - Yen-Hung Lin
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Primary Aldosteronism Center, National Taiwan University Hospital, (NTUH-PAC), Taipei, Taiwan
- TAIPAI, Taiwan Primary Aldosteronism Investigation (TAIPAI) Study Group, Taipei, Taiwan
| | - Vin-Cent Wu
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan.
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
- Primary Aldosteronism Center, National Taiwan University Hospital, (NTUH-PAC), Taipei, Taiwan.
- TAIPAI, Taiwan Primary Aldosteronism Investigation (TAIPAI) Study Group, Taipei, Taiwan.
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Ohashi M, Aoyagi Y, Ito S, Kagaya H, Hirata M, Nakata S. Comparison of electromyography, sound, bioimpedance, and high-resolution manometry for differentiating swallowing and vocalization events. Med Eng Phys 2023; 115:103980. [PMID: 37120175 DOI: 10.1016/j.medengphy.2023.103980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 03/09/2023] [Accepted: 04/09/2023] [Indexed: 05/01/2023]
Abstract
OBJECTIVES Non-invasive surface recording devices used for detecting swallowing events include electromyography (EMG), sound, and bioimpedance. However, to our knowledge there are no comparative studies in which these waveforms were recorded simultaneously. We assessed the accuracy and efficiency of high-resolution manometry (HRM) topography, EMG, sound, and bioimpedance waveforms, for identifying swallowing events. METHODS Six participants randomly performed saliva swallow or vocalization of "ah" 62 times. Pharyngeal pressure data were obtained using an HRM catheter. EMG, sound, and bioimpedance data were recorded using surface devices on the neck. Six examiners independently judged whether the four measurement tools indicated a saliva swallow or vocalization. Statistical analyses included the Cochrane's Q test with Bonferroni correction and the Fleiss' kappa coefficient. RESULTS Classification accuracy was significantly different between the four measurement methods (P < 0.001). The highest classification accuracy was for HRM topography (>99%), followed by sound and bioimpedance waveforms (98%), then EMG waveform (97%). The Fleiss' kappa value was highest for HRM topography, followed by bioimpedance, sound, and then EMG waveforms. Classification accuracy of the EMG waveform showed the greatest difference between certified otorhinolaryngologists (experienced examiners) and non-physicians (naive examiners). CONCLUSION HRM, EMG, sound, and bioimpedance have fairly reliable discrimination capabilities for swallowing and non-swallowing events. User experience with EMG may increase identification and interrater reliability. Non-invasive sound, bioimpedance, and EMG are potential methods for counting swallowing events in screening for dysphagia, although further study is needed.
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Affiliation(s)
- Miho Ohashi
- Department of Rehabilitation Medicine, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan; Department of Rehabilitation, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Yoichiro Aoyagi
- Department of Rehabilitation Medicine, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan; Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan.
| | - Satoshi Ito
- Department of Otorhinolaryngology and Sleep Medicine, School of Medicine, Fujita Health University, Nagoya, Japan
| | - Hitoshi Kagaya
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Masatoshi Hirata
- Department of Clinical Laboratory, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Seiichi Nakata
- Department of Otorhinolaryngology and Sleep Medicine, School of Medicine, Fujita Health University, Nagoya, Japan
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18
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Ha GB, Steinberg BA, Freedman R, Bayés-Genís A, Sanchez B. Safety evaluation of smart scales, smart watches, and smart rings with bioimpedance technology shows evidence of potential interference in cardiac implantable electronic devices. Heart Rhythm 2023; 20:561-571. [PMID: 36997272 DOI: 10.1016/j.hrthm.2022.11.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/21/2022] [Accepted: 11/27/2022] [Indexed: 02/24/2023]
Abstract
BACKGROUND Smart scales, smart watches, and smart rings with bioimpedance technology may create interference in patients with cardiac implantable electronic devices (CIEDs). OBJECTIVES The purpose of this study was to determine interference at CIEDs with simulations and benchtop testing, and to compare the results with maximum values defined in the ISO 14117 electromagnetic interference standard for these devices. METHODS The interference at pacing electrodes was determined by simulations on a male and a female computable model. A benchtop evaluation of representative CIEDs from 3 different manufacturers as specified in the ISO 14117 standard also was performed. RESULTS Simulations showed evidence of interference with voltage values exceeding threshold values defined in the ISO 14117 standard. The level of interference varied with the frequency and amplitude of the bioimpedance signal, and between male and female models. The level of interference generated with smart scale and smart rings simulations was lower than with smart watches. Across device manufacturers, generators demonstrated susceptibility to oversensing and pacing inhibition at different signal amplitudes and frequencies. CONCLUSIONS This study evaluated the safety of smart scales, smart watches, and smart rings with bioimpedance technology via simulation and testing. Our results indicate that these consumer electronic devices could interfere in patients with CIEDs. The present findings do not recommend the use of these devices in this population due to potential interference.
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Affiliation(s)
- Gia-Bao Ha
- Department of Electrical and Computer Engineering, University of Utah, Salt Lake City, Utah
| | - Benjamin A Steinberg
- Department of Medicine, University of Utah Health Sciences Center, Salt Lake City, Utah
| | - Roger Freedman
- Department of Medicine, University of Utah Health Sciences Center, Salt Lake City, Utah
| | - Antoni Bayés-Genís
- Department of Cardiology, Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Autonomous University of Barcelona, Barcelona, Spain
| | - Benjamin Sanchez
- Department of Electrical and Computer Engineering, University of Utah, Salt Lake City, Utah.
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Gupta V, Agrawal U, Goel P. Bioimpedance: A Tool for Screening Oral Cancer - A Systematic Review. Contemp Clin Dent 2023; 14:91-97. [PMID: 37547441 PMCID: PMC10399808 DOI: 10.4103/ccd.ccd_195_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/31/2023] [Accepted: 06/09/2023] [Indexed: 08/08/2023] Open
Abstract
Objective The successful management of cancer depends on proper screening and treatment methods. Bioimpedance spectroscopy (BIS) is an established technique in detecting breast cancer, cervical cancer, and prostate cancer. This systematic review sought to investigate the current evidence regarding the clinical application of bioimpedance in the detection of oral squamous cell carcinoma and oral potentially malignant disorders. Study Design The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to perform this review. Electronic databases such as PubMed, MEDLINE, Embase, EBSCOhost, and Google Scholar were searched till March 2022. Articles published in the English medical literature on human participants report on the application of BIS in the screening of precancerous and cancerous lesions. The primary endpoint was defined as the ability to differentiate between normal and cancerous tissue. Results A total of 6754 articles were identified; of which 481 were eligible for inclusion. Only five articles met the eligibility criteria and were included in the study. Qualitative analysis for each study was done to assess the data provided. All the studies demonstrated a significant divergence in BIS metrics between cancerous and normal tissue at 20 Hz and 50 KHz. Conclusion Bioimpedance appears to be a promising novel tool for the detection of various malignancies which can be used in community screening due to its noninvasiveness and portability.
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Affiliation(s)
- Vaibhav Gupta
- CRIB Lab, National Institute of Pathology - ICMR, Delhi, India
| | - Usha Agrawal
- CRIB Lab, National Institute of Pathology - ICMR, Delhi, India
| | - Poonam Goel
- CRIB Lab, National Institute of Pathology - ICMR, Delhi, India
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20
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Blue MNM, Tinsley GM, Hirsch KR, Ryan ED, Ng BK, Smith-Ryan AE. Validity of total body water measured by multi-frequency bioelectrical impedance devices in a multi-ethnic sample. Clin Nutr ESPEN 2023; 54:187-193. [PMID: 36963862 DOI: 10.1016/j.clnesp.2023.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND & AIMS Total body water (TBW) is the largest component of fat free mass and therefore is commonly used in multi-compartment body composition models and as a stand-alone method to assess body composition. Previous literature has not validated bioelectrical impedance spectroscopy device estimates of TBW in racial and ethnic minority populations; previous studies have focused on bioelectrical impedance analysis devices that rely on proprietary algorithms and participant characteristics for accuracy. The purpose of this study was to assess the validity of two bioelectrical impedance spectroscopy devices for measures of TBW compared to a deuterium dilution criterion in a multi-ethnic sample. METHODS 109 individuals (55% female, Age: 26.6 ± 6.9 yrs, BMI: 25.3 ± 4.0 kg/m2) identifying as Asian, African American/Black, Caucasian/White, Hispanic, and Multi-racial were enrolled. After a 12 h fast, participants provided a saliva sample for the criterion baseline TBW measure and completed two bioelectrical impedance device (BIS, IB) measurements of TBW. Participants then ingested deuterium oxide (D2O). After an equilibration period, participants provided a second saliva sample for analysis of TBW. RESULTS For the total multi-ethnic sample, BIS estimates demonstrated good to fairly good agreement (Total error [TE] = 2.56 L, R2 = 0.951) and IB estimates were excellent to very good (TE = 1.95 L, R2 = 0.975). Validity results did not vary meaningfully between race and ethnicity. CONCLUSIONS The results suggest the BIS and IB devices evaluated can produce valid TBW estimates compared to D2O in a multi-ethnic sample. TBW estimates from the IB may have better agreement with D2O compared to the BIS when using the default settings.
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Affiliation(s)
- Malia N M Blue
- Department of Exercise and Sport Science, The University of North Carolina, Chapel Hill, NC, 27599, USA.
| | - Grant M Tinsley
- Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX, 79409, USA
| | - Katie R Hirsch
- Department of Exercise Science, University of South Carolina, Columbia, SC, 29208, USA
| | - Eric D Ryan
- Department of Exercise and Sport Science, The University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Bennett K Ng
- Emerging Growth and Incubation Group, Intel Corporation, Santa Clara, CA, USA
| | - Abbie E Smith-Ryan
- Department of Exercise and Sport Science, The University of North Carolina, Chapel Hill, NC, 27599, USA; Department of Nutrition, The University of North Carolina, Chapel Hill, NC, 27599, USA
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21
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Tolosa-Álvarez S, Arévalo-Lorido JC, Sánchez-Muñoz-Torrero JF, Pijierro-Amador A, Nevado López-Alegría L, Carretero-Gómez J. Association between arterial stiffness and fat mass in patients with obesity. Rev Clin Esp 2023; 223:176-180. [PMID: 36709045 DOI: 10.1016/j.rceng.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE The aim is to observe whether body composition in patients with high-risk obesity (body mass index >35 or between 30 and 34.9kg/m2 with a waist circumference greater than 102cm in men or greater than 88cm in women) is related with vascular disease. METHODS This is a cross-sectional study of patients with high-risk obesity. Their fat mass was measured through bioimpedance and arterial stiffness through pulse wave velocity (PWV). Tertiles of patients were analyzed according to PWV distribution. RESULTS A total of 59 patients were analyzed. As PWV increased, BMI (p=0.02) and fat mass content (p<0.00) increased. There was also a significant increase in inflammation indicators. CONCLUSIONS In patients with high-risk obesity, there were differences in their body composition which were associated with changes in arterial stiffness and inflammatory burden.
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Affiliation(s)
- S Tolosa-Álvarez
- Servicio de Medicina Interna, Hospital Universitario de Badajoz, Badajoz, Spain
| | - J C Arévalo-Lorido
- Servicio de Medicina Interna, Hospital Universitario de Badajoz, Badajoz, Spain.
| | | | - A Pijierro-Amador
- Servicio de Medicina Interna, Hospital Universitario de Badajoz, Badajoz, Spain
| | | | - J Carretero-Gómez
- Servicio de Medicina Interna, Hospital Universitario de Badajoz, Badajoz, Spain
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22
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Abstract
Measurement of phase angle using bioimpedance analysis (BIA) has become popular as an index of so-called "cellular health". What precisely is meant by this term is not always clear but strong relationships have been found between cellular water status (the relative amounts of extra- and intracellular water), cell membrane integrity and cellular mass. Much of the current research is empirical observation and frequently pays little regard to the underlying biophysical models that underpin the BIA technique or attempts to provide mechanistic explanations for the observations. This brief review seeks to provide a basic understanding of the electrical models frequently used to describe the passive electrical properties of tissues with particular focus on phase angle. In addition, it draws attention to some practical concerns in the measurement of phase angle and notes the additional understanding that can be gained when phase angle are obtained with bioimpedance spectroscopy (BIS) rather than single frequency BIA (SFBIA) along with the potential for simulation modelling.
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Affiliation(s)
- Leigh C Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Brisbane, 4072, Australia.
| | - Steven Brantlov
- Department of Procurement and Clinical Engineering, Central Denmark Region, Aarhus, Denmark
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23
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Mayrink Ivo JF, Sugizaki CSA, Souza Freitas ATV, Costa NA, Peixoto MDRG. Age, hemodialysis time, gait speed, but not mortality, are associated with muscle quality index in end-stage renal disease. Exp Gerontol 2023; 171:112035. [PMID: 36436759 DOI: 10.1016/j.exger.2022.112035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 10/30/2022] [Accepted: 11/18/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND The muscle quality index (MQI) has proven to be an interesting clinical measurement in hemodialysis (HD) patients. In clinical practice, its interpretation can be biased by fat mass (FM) distribution. This study aims to explore the arm MQI association with body composition, clinical factors, and mortality. METHODS It was analytical longitudinal and exploratory, that included patients from two-center, over 18 years old, of both genders in treatment by HD. The follow-up period was 32 months, and mortality was the clinical outcome. Demographical and clinical data were collected in the patient's medical records. Body composition was evaluated using octopolar multi-frequency bioelectrical impedance analysis (MF-BIA). Handgrip strength (HGS) was measured by a dynamometer and the time required to walk 3 m was applied to obtain gait speed. The baseline associations with MQI (HGS/arm muscle mass) were examined by multivariate linear regression. Cox regressions evaluated the associations with mortality. RESULTS A total of 97 patients in HD were included. Mean age was 50.93 ± 14.10 years, 71.13 % were male. Age (β = -0,096, p = 0.024), HD time (β = -0.023, p = 0.032), total skeletal muscle mass (β = -0.475, p < 0.001) were inversely associated with MQI and gait speed had a direct association with MQI (β = 8514, p = 0.002). The prevalence of mortality was 29.76 %, of which 37.29 % were men (p = 0.020). Low MQI was not associated with mortality (Hz = 0.80, CI95 % = 0.34; 1.91, p = 0.629). CONCLUSION The arm MQI was associated with an indicator of general functional capacity (gait speed), but was not associated with fat measures in baseline and mortality after 32 months of follow-up.
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Affiliation(s)
- Jessica F Mayrink Ivo
- Postgraduate Program in Nutrition and Health, Federal University of Goiás, Goiânia, Brazil
| | - Clara S A Sugizaki
- Postgraduate Program in Nutrition and Health, Federal University of Goiás, Goiânia, Brazil
| | | | - Nara Aline Costa
- Postgraduate Program in Nutrition and Health, Federal University of Goiás, Goiânia, Brazil
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24
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Matur F, Ülgen Y. The complex impedance phase angle of dominant arm: a useful parameter in bone mineral density (BMD) assessment of group 1 post-menopausal women. Med Biol Eng Comput 2023; 61:25-32. [PMID: 36306050 DOI: 10.1007/s11517-022-02669-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 09/17/2022] [Indexed: 01/07/2023]
Abstract
For widespread osteoporosis (OP) screening, portable and cost-effective screening devices are needed. With 45 menopaused women, when body mass index was below 30 kg.m- 2, the phase angle (PhA) of complex bioimpedance at 5 kHz, measured from the dominant arm, was correlated with dual-energy X-ray absorptiometry (DEXA) measured central bone mineral densities (BMD), for total hip r = 0.493 and for total lumbar r = 0.411, P< 0.05, and the strength of correlation decreased with increasing measurement frequencies. ANOVA tests showed that, below 15 kHz, PhA was a descriptive marker for bone mineral deficiency. By correlating to hip and lumbar bone mineral densities simultaneously, the dominant arm segment PhA was superior to the characteristic frequency fc of the body impedance spectroscopy (BIS) and the PhA of whole-body impedance measurements, of the earlier research works. Due to its medium correlation strength with central BMDs, a PhA measuring device could be considered as a complementary tool to the gold standard (DEXA), for OP screening of group 1 post-menopausal women only. For group 2, with 44 subjects with body mass indices over 30 kg.m- 2, i.e., obese population, the PhA was not correlated with BMD and was no longer a descriptive marker for reduced BMD.
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Affiliation(s)
- Fırat Matur
- Canon Eurasia, Kozyatağı, Değirmen Sk. Nida Kule İş Merkezi No:18 D:10, 34742, Istanbul, Turkey.
| | - Yekta Ülgen
- Bahçeşehir University, Yıldız, Çırağan Cd., 34349 Beşiktaş, Istanbul, Turkey
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25
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Marinier MC, Ogunsola AS, Elkins JM. Whole-body phase angle correlates with pre-operative markers in total joint arthroplasty. J Electr Bioimpedance 2023; 14:60-65. [PMID: 38162816 PMCID: PMC10750321 DOI: 10.2478/joeb-2023-0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Indexed: 01/03/2024]
Abstract
Background Bioimpedance derived whole body phase angle (ϕ), a measure of cellular integrity, has been identified as an independent marker of morbidity and mortality in many medical and surgical specialties. While similar measures of water homeostasis like extracellular edema (EE) have been associated with pre-operative risk, ϕ has not been studied in orthopaedics, despite potential to serve as a pre-operative marker. This study aims to identify relationships between ϕ, EE, and body composition metrics, laboratory values, patient reported outcomes, and comorbidities. Methods Multi-frequency bioimpedance analysis (BIA) records, laboratory values, and patient reported outcomes of adult patients presenting to an academic arthroplasty clinic were retrospectively reviewed. Correlation coefficients between ϕ, EE, and reviewed information were conducted. Results ϕ was significantly correlated (p<0.001) most positively with measures of lean tissue such as skeletal muscle mass (r=0.48), appendicular skeletal muscle index (r=0.39), lean body mass (r=0.43), and dry lean mass (r=0.47), while it held negative correlations (p<0.001) with age (r= -0.55), and body fat mass (r= -0.11). ϕ was not correlated with body mass index (BMI, p = 0.204). In contrast, EE demonstrated its strongest positive correlations (p<0.001) with body fat mass (r=0.32), age (r=0.50), and BMI (r=0.26), and its strongest negative correlations (p<0.001) with serum albumin (r= -0.37) and total protein (r= -0.23). Conclusions Based on their associations with markers of health and fitness, BIA determined ϕ and EE demonstrate relationships to markers currently implemented in orthopaedic practice. This likely indicates that ϕ has potential as a comprehensive surrogate for several commonly used markers to quantify pre-operative risk. In the future, ϕ may aid in developing risk-stratifications for intervention and prevention of complications.
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Affiliation(s)
- Michael C. Marinier
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA USA
| | - Ayobami S. Ogunsola
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA USA
| | - Jacob M. Elkins
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA USA
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Whelton E, Helen L, O’Donnell B, O’Sullivan M, Ugwah J, Messina W, Wang Y, O’Mahoney N, Moore E. Smart needle electrical bioimpedance to provide information on needle tip relationship to target nerve prior to local anesthetic deposition in peripheral nerve block (USgPNB) procedures. J Electr Bioimpedance 2023; 14:53-59. [PMID: 38162814 PMCID: PMC10750317 DOI: 10.2478/joeb-2023-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Indexed: 01/03/2024]
Abstract
Ultrasound guided peripheral nerve block (USgPNB) refers to anaesthetic techniques to deposit local anesthetic next to nerves, permitting painful surgery without necessitating general anesthesia. Needle tip position prior to local anesthetic deposition is a key determinant of block success and safety. Nerve puncture and intra-neural injection of local anesthetic can cause permanent nerve injury. Currently ultrasound guidance is not sufficiently sensitive to reliably detect needle to nerve proximity. Feedback with bioimpedance data from the smart needle tip might provide the anesthetist with information as to the relationship between the needle tip and the target nerve prior to local anesthetic deposition. Bioimpedance using a smart needle integrated with a two-electrode impedance sensor has been developed to determine needle to nerve proximity during USgPNB. Having obtained all necessary ethical and regulatory approvals, in vivo data on brachial plexus, vagus, femoral and sciatic nerves were obtained from seven pig models using the smart needle bioimpedance system. The excision and histological analysis of above peripheral nerves and observation of the architecture and structure of nerves by means of histology allow the calculation of the ratios of connective tissue to neural tissue to determine the influence of this variable on absolute impedance. The ratio results give extra clinical data and explain the hetrogeneity of impedance data in the pig models and the hypothesis that connective tissue with intra-neural fat has higher impedance than neural tissue.
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Affiliation(s)
- Edel Whelton
- Life Science Interface, Tyndall National Institute, University College, Cork, Ireland
- School of Chemistry, University CollegeCork, Ireland
| | - Lisa Helen
- Life Science Interface, Tyndall National Institute, University College, Cork, Ireland
| | | | | | - Justina Ugwah
- Life Science Interface, Tyndall National Institute, University College, Cork, Ireland
- School of Chemistry, University CollegeCork, Ireland
| | - Walter Messina
- Life Science Interface, Tyndall National Institute, University College, Cork, Ireland
| | - Yineng Wang
- Life Science Interface, Tyndall National Institute, University College, Cork, Ireland
| | | | - Eric Moore
- Life Science Interface, Tyndall National Institute, University College, Cork, Ireland
- School of Chemistry, University CollegeCork, Ireland
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27
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Dou Y, Gong Y, Li A, Wang P, Song D, Wang Y, Liu D, Cheng G, Zhao Z. A comparison of fluid status determination using bioelectric impedance and the isotope dilution method in hemodialysis and peritoneal dialysis patients. Ren Fail 2022; 44:1698-1707. [PMID: 36262107 PMCID: PMC9586612 DOI: 10.1080/0886022x.2022.2132960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We aimed to compare fluid status as determined by multifrequency bioimpedance spectroscopy (MF-BIS, Xitron 4200, USA) with that determined by the isotope dilution method among a contemporary Chinese cohort. Healthy Chinese subjects (HS, n = 30) were recruited in Zhengzhou. Hemodialysis (HD, n = 49) and peritoneal dialysis (PD, n = 48) patients were screened at the First Affiliated Hospital of Zhengzhou University. Total body water (TBW) and extracellular water (ECW) were measured by deuterium (TBWD) and bromide (ECWBr) dilution, respectively, and by MF-BIS using the Moissl equation (ME). The results of MF-BIS were compared to the reference method by Pearson analysis and Bland–Altman analysis in the three groups. The accuracy of overhydration as determined by MF-BIS was analyzed by receiver operating characteristic (ROC) curves. The TBWD and TBWME values were 34.67 ± 7.31 and 35.41 ± 5.76 L, 37.30 ± 8.58 and 37.02 ± 8.10 L, and 38.61 ± 10.02 and 38.44 ± 7.59 L in the HS, HD and PD groups, respectively. The ECWBr and ECWME values were 14.88 ± 3.33 and 15.53 ± 2.39 L, 16.24 ± 5.08 and 16.90 ± 3.93 L, and 19.08 ± 6.41 and 18.23 ± 3.61 L in the HS, HD and PD groups, respectively. The mean bias between TBWD and TBWME was −0.74 L, 0.28 L, and 0.17 L in the HS, HD and PD groups, respectively. The mean bias between ECWBr and ECWME was −0.65 L, −0.66 L, and 0.85 L in the HS, HD and PD groups, respectively. Compared to the ECWBr/TBWD ratio, the area under the ROC curve (AUC) of the ECWME/TBWME ratio for the diagnosis of overhydration was 0.76 and 0.68 in the HD and PD groups, respectively. In summary, MF-BIS with ME could be used in Chinese HD and PD patients.
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Affiliation(s)
- Yanna Dou
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yanan Gong
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Afang Li
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Peipei Wang
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Dongyan Song
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yuyang Wang
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Dong Liu
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Genyang Cheng
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Zhanzheng Zhao
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Martins AD, Fernandes O, Oliveira R, Bilro V, Lopes G, Rego AM, Parraça JA, Raimundo AMM, Brito JP. Effects of exercise programs on phase angle in older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr 2022; 103:104787. [PMID: 35961106 DOI: 10.1016/j.archger.2022.104787] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/31/2022] [Accepted: 08/04/2022] [Indexed: 11/02/2022]
Abstract
The purpose of this study was to calculate the effects of exercise programs on phase angle (PhA) in older people. A systematic review was undertaken in multiple electronic databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement guidelines for the purposes of selecting randomized controlled trials that measured the effects of the exercise programs on PhA in older adults on 31 March 2022. We carried out a random-effect meta-analysis for the effects of exercise programs on PhA. Additionally, we analysed the differences between subgroups in terms of weekly frequency, number of sets and repetitions, and duration of interventions. Studies were methodological assessed through the PEDro scale where one had excellent, ten had good, and three had poor methodological quality. For the purposes of the study, fourteen studies met the criteria for inclusion. However, four studies did not have enough information to be included in the quantitative analysis. The remaining ten articles revealed moderate effects on PhA in favour of intervention groups (p=0.009, SMD=0.72 [0.46-0.99], I2=54%). The meta-analysis also showed that interventions lasting twelve weeks are more successful in generating positive effects on PhA as opposed to eight weeks (SMD's=0.79 vs. 0.64, respectively). These results indicate that resistance training (RT) is an effective and safe to improve PhA in the older people, especially through RT programs lasting from eight to twelve weeks. A novel finding of this study was that RT is the most used type of exercise by authors when assessing the PhA in older adults.
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Affiliation(s)
- Alexandre Duarte Martins
- Comprehensive Health Research Centre (CHRC), Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, 7004-516, Évora 7000-727, Portugal; Sports Science School of Rio Maior, Polytechnic Institute of Santarém, Rio Maior 2040-413, Portugal; Life Quality Research Centre, Rio Maior 2040-413, Portugal.
| | - Orlando Fernandes
- Comprehensive Health Research Centre (CHRC), Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, 7004-516, Évora 7000-727, Portugal
| | - Rafael Oliveira
- Sports Science School of Rio Maior, Polytechnic Institute of Santarém, Rio Maior 2040-413, Portugal; Life Quality Research Centre, Rio Maior 2040-413, Portugal; Research Centre in Sport Sciences, Health Sciences and Human Development, Vila Real 5001-801, Portugal
| | - Vitor Bilro
- Comprehensive Health Research Centre (CHRC), Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, 7004-516, Évora 7000-727, Portugal
| | - Gabriel Lopes
- Comprehensive Health Research Centre (CHRC), Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, 7004-516, Évora 7000-727, Portugal
| | - António Maia Rego
- Comprehensive Health Research Centre (CHRC), Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, 7004-516, Évora 7000-727, Portugal
| | - José A Parraça
- Comprehensive Health Research Centre (CHRC), Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, 7004-516, Évora 7000-727, Portugal
| | - Armando Manuel Mendonça Raimundo
- Comprehensive Health Research Centre (CHRC), Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, 7004-516, Évora 7000-727, Portugal
| | - João Paulo Brito
- Sports Science School of Rio Maior, Polytechnic Institute of Santarém, Rio Maior 2040-413, Portugal; Life Quality Research Centre, Rio Maior 2040-413, Portugal; Research Centre in Sport Sciences, Health Sciences and Human Development, Vila Real 5001-801, Portugal
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29
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Kumar S, Victoria-Castro AM, Melchinger H, O'Connor KD, Psotka M, Desai NR, Ahmad T, Wilson FP. Wearables in Cardiovascular Disease. J Cardiovasc Transl Res 2022. [PMID: 36085432 DOI: 10.1007/s12265-022-10314-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 08/29/2022] [Indexed: 10/14/2022]
Abstract
Wearable devices stand to revolutionize the way healthcare is delivered. From consumer devices that provide general health information and screen for medical conditions to medical-grade devices that allow collection of larger datasets that include multiple modalities, wearables have a myriad of potential uses, especially in cardiovascular disorders. In this review, we summarize the underlying technologies employed in these devices and discuss the regulatory and economic aspects of such devices as well as the future implications of their use.
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30
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Ng JKC, Kwan BCH, Chan GCK, Chow KM, Pang WF, Cheng PMS, Leung CB, Li PKT, Szeto CC. Predictors and prognostic significance of persistent fluid overload: A longitudinal study in Chinese peritoneal dialysis patients. ARCH ESP UROL 2022:8968608221110491. [PMID: 35787209 DOI: 10.1177/08968608221110491] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cross-sectional studies showed that fluid overload (FO) measured by bioimpedance spectroscopy (BIS) predicted adverse outcomes in patients on peritoneal dialysis (PD). We aimed to describe the longitudinal change in volume status in Chinese PD patients and determine its relation with clinical outcomes. METHODS We performed a single-centre, retrospective analysis of all PD patients who underwent repeated BIS from 2010 to 2015. FO was defined by relative hydration index (RHI; volume of overhydration adjusted by extracellular water >7%). Variability of volume status (VVS) was denoted by the standard deviation of all RHI. The association of time-averaged RHI and VVS on patient and technique survival was explored by a competing risk model. RESULTS A total of 269 patients were followed for a median of 47.1 months. Mean time-averaged RHI was 17.6 ± 10.2%. Multivariable mixed linear regression revealed that RHI was significantly associated with diabetes, time-varying systolic blood pressure, and inversely with time-varying albumin level, lean tissue index and fat tissue index (p <0.0001 for all). Time-averaged RHI independently predicted patient survival (subdistribution hazard ratio (SHR) 1.05, 95% CI 1.03-1.07, p <0.0001) and technique survival (SHR 1.04, 95% CI 1.02-1.06, p <0.0001), whereas VVS did not. The mortality risk for patients with persistent FO was consistently higher than the corresponding risk estimated from baseline FO of the same extent. CONCLUSIONS Persistent FO was a strong predictor of patient and technique failure. Repeated bioimpedance measurements to monitor volume status may provide additional prognostic information in PD patients.
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Affiliation(s)
- Jack Kit-Chung Ng
- Carol and Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Bonnie Ching-Ha Kwan
- Carol and Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences (LiHS), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Gordon Chun-Kau Chan
- Carol and Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kai Ming Chow
- Carol and Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wing Fai Pang
- Carol and Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Phyllis Mei-Shan Cheng
- Carol and Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chi Bon Leung
- Carol and Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Philip Kam-Tao Li
- Carol and Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Cheuk Chun Szeto
- Carol and Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences (LiHS), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
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Tinsley GM, Harty PS, Stratton MT, Smith RW, Rodriguez C, Siedler MR. Tracking changes in body composition: comparison of methods and influence of pre-assessment standardisation. Br J Nutr 2022; 127:1656-74. [PMID: 34325758 DOI: 10.1017/S0007114521002579] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The present study reports the validity of multiple assessment methods for tracking changes in body composition over time and quantifies the influence of unstandardised pre-assessment procedures. Resistance-trained males underwent 6 weeks of structured resistance training alongside a hyperenergetic diet, with four total body composition evaluations. Pre-intervention, body composition was estimated in standardised (i.e. overnight fasted and rested) and unstandardised (i.e. no control over pre-assessment activities) conditions within a single day. The same assessments were repeated post-intervention, and body composition changes were estimated from all possible combinations of pre-intervention and post-intervention data. Assessment methods included dual-energy X-ray absorptiometry (DXA), air displacement plethysmography, three-dimensional optical imaging, single- and multi-frequency bioelectrical impedance analysis, bioimpedance spectroscopy and multi-component models. Data were analysed using equivalence testing, Bland-Altman analysis, Friedman tests and validity metrics. Most methods demonstrated meaningful errors when unstandardised conditions were present pre- and/or post-intervention, resulting in blunted or exaggerated changes relative to true body composition changes. However, some methods - particularly DXA and select digital anthropometry techniques - were more robust to a lack of standardisation. In standardised conditions, methods exhibiting the highest overall agreement with the four-component model were other multi-component models, select bioimpedance technologies, DXA and select digital anthropometry techniques. Although specific methods varied, the present study broadly demonstrates the importance of controlling and documenting standardisation procedures prior to body composition assessments across distinct assessment technologies, particularly for longitudinal investigations. Additionally, there are meaningful differences in the ability of common methods to track longitudinal body composition changes.
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Ben-David M, Carmeli I, Orgad R, Nathansohn-Levi B, Yered T, Shor E, Wasserberg N. Implantation of an Impedance Sensor for Early Detection of Gastrointestinal Anastomotic Leaks. J Surg Res 2022; 278:49-56. [PMID: 35594614 DOI: 10.1016/j.jss.2022.04.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 04/07/2022] [Accepted: 04/08/2022] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Accurate early diagnosis of a gastrointestinal anastomotic leak remains a challenge. When an anastomotic leak develops, the electrical properties of the tissue undergoing inflammatory processes change, resulting from the extravasation of inflammatory fluid and cellular infiltration. The method described here intends to provide a novel early anastomotic leak warning system based upon measurable changes in tissue impedance nearby an acute inflammatory process. METHODS A biodegradable Mg-alloy was compared with a nonabsorbable stainless steel (STS) electrode connected to a wireless recording system for impedance measurement. In vitro measurements were made in physiological solutions and small animal (eight mice) and large animal (eight pigs) models with an anastomotic leak simulated by an open colotomy. Measurements were made at 10 mm intervals from the open colon at baseline and up to 120 min comparing these with a sutured colonic wound and normal tissue. RESULTS In-vitro biodegradable magnesium electrode impedance evaluation showed good sensitivity to different media due to its environmental corrosion properties. The impedance of an acidic environment (1.06 ± 0.02 kΩ for citric acid) was twice that of phosphate-buffered saline (PBS) (0.64 ± 0.008 kΩ) with a distinction between Normal Saline (0.42 ± 0.013 kΩ) and PBS (0.64 ± 0.008 kΩ). This was in contrast to the performance characteristics of the control STS electrodes, where impedance in an acidic environment was lower than saline or PBS (citric acid:0.76 ± 0.01 kΩ versus PBS: 1.32 ± 0.014 kΩ). In a mouse model simulating an anastomotic leak, there was a significant increase in impedance after 120 min when compared with controls (99.7% increase versus 9.6% increase, respectively; P < 0.02). This effect was confirmed in a pig model when relative impedance measurements of the leak and control groups were compared (1.86 ± 0.46 versus 1.07 ± 0.02, respectively; P < 0.027). CONCLUSIONS Electrophysiological measurement shows diagnostic sensitivity for a gastrointestinal leak with potential clinical utility in the postoperative detection of early intra-abdominal sepsis. Further investigation of biodegradable tissue sensors capable of monitoring an early anastomotic leak is required.
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Affiliation(s)
- Matan Ben-David
- Upper GI Surgery, Royal Prince Alfred Hospital, University of Sydney, Australia.
| | - Idan Carmeli
- General Surgery, Assuta Ashdod Public Hospital, Ashdod, Israel
| | - Ran Orgad
- Department of Surgery, Rabin Medical Center, Petach Tiqva, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Tal Yered
- Exero Medical LTD, Or Yehuda, Israel
| | - Erez Shor
- Exero Medical LTD, Or Yehuda, Israel
| | - Nir Wasserberg
- Department of Surgery, Rabin Medical Center, Petach Tiqva, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Polcz M, Huston J, Breed M, Case M, Leisy P, Schmeckpeper J, Vaughn L, Sobey JH, Brophy C, Lindenfeld J, Hocking K, Alvis B. Comparison of clinical symptoms and bioimpedance to pulmonary capillary wedge pressure in heart failure. Am Heart J Plus 2022; 15:100133. [PMID: 35600671 PMCID: PMC9119644 DOI: 10.1016/j.ahjo.2022.100133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 04/03/2022] [Accepted: 04/03/2022] [Indexed: 11/18/2022]
Abstract
Introduction Clinical symptoms of heart failure commonly include fatigue, edema, and shortness of breath. Unfortunately, clinical monitoring has proven unreliable in predicting congestion and the need for hospitalization. Biosensing wearables have been developed as a potential adjunct to clinical signs and symptoms to detect congestion before it becomes severe thus preventing a heart failure hospitalization. Hypothesis Clinical signs and symptoms of heart failure will correlate with thoracic bioimpedance measurements (ZOE®) and pulmonary capillary wedge pressure (PCWP). Methods One hundred and fifty-five subjects undergoing right heart catheterization (RHC) were prospectively enrolled. A Zo value (ohms) was obtained, jugular venous pressure (JVP) was estimated, edema graded, and shortness of breath (SOB) assessed in all subjects. RHC was performed by a scheduled cardiologist per routine. One-way ANOVA was performed to assess the relationship between variables. A Pearson correlation coefficient was used to compare the Zo value and PCWP. Results Neither estimated JVP (cmH2O) (p = 0.65, n = 110) nor edema scores (p = 0.12, n = 110) demonstrated a significant relationship to PCWP. The presence of subjective SOB also did not demonstrate a significant association with PCWP (p = 0.99, n = 110). There was no correlation between ZOE® and PCWP (r = -0.08, p = 0.56, n = 56). Conclusions These findings support the idea that traditional measures for monitoring heart failure patients are limited.
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Affiliation(s)
- Monica Polcz
- Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jessica Huston
- Department of Medicine, Division of Cardiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Meghan Breed
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Marisa Case
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Philip Leisy
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jeffrey Schmeckpeper
- Department of Medicine, Division of Cardiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lexie Vaughn
- Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jenna Helmer Sobey
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Colleen Brophy
- Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - JoAnn Lindenfeld
- Department of Medicine, Division of Cardiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kyle Hocking
- Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Bret Alvis
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
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Halonen S, Ovissi A, Boyd S, Kari J, Kronström K, Kosunen J, Lauren H, Numminen K, Sievänen H, Hyttinen J. Human in vivoliver and tumor bioimpedance measured with biopsy needle. Physiol Meas 2022; 43. [PMID: 35051907 DOI: 10.1088/1361-6579/ac4d38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 01/20/2022] [Indexed: 11/11/2022]
Abstract
Objective:Liver biopsy is an essential procedure in cancer diagnostics but targeting the biopsy to the actual tumor tissue is challenging. Aim of this study was to evaluate the clinical feasibility of a novel bioimpedance biopsy needle system in liver biopsy and simultaneously to gatherin vivobioimpedance data from human liver and tumor tissues.Approach:We measured human liver and tumor impedance datain vivofrom 26 patients who underwent diagnostic ultrasound-guided liver biopsy. Our novel 18G core biopsy needle tip forms a bipolar electrode that was used to measure bioimpedance during the biopsy in real-time with frequencies from 1 kHz to 349 kHz. The needle tip location was determined by ultrasound. Also, the sampled tissue type was determined histologically.Main results:The bioimpedance values showed substantial variation between individual cases, and liver and tumor data overlapped each other. However, Mann-Whitney U test showed that the median bioimpedance values of liver and tumor tissue are significantly (p<0.05) different concerning the impedance magnitude at frequencies below 25 kHz and the phase angle at frequencies below 3 kHz and above 30 kHz.Significance:This study uniquely employed a real-time bioimpedance biopsy needle in clinical liver biopsies and reported the measured humanin vivoliver and tumor impedance data. Impedance is always device-dependent and therefore not directly comparable to measurements with other devices. Although the variation in tumor types prevented coherent tumor identification, our study provides preliminary evidence that tumor tissue differs from liver tissuein vivoand this association is frequency-dependent.
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Affiliation(s)
- Sanna Halonen
- R&D Department, Injeq, Biokatu 8, Tampere, 33520, FINLAND
| | - Ali Ovissi
- Department of Radiology, Meilahti Hospital, Haartmaninkatu 4, Helsinki, Uusimaa, 00029, FINLAND
| | - Sonja Boyd
- HUS Diagnostic Center, Helsinki University Hospital Pathology, PB 340, Helsinki, 00029, FINLAND
| | - Juho Kari
- R&D Department, Injeq, Biokatu 8, Tampere, 33520, FINLAND
| | | | - Juhani Kosunen
- Department of Radiology, Meilahti Hospital, Haartmaninkatu 4, Helsinki, Uusimaa, 00029, FINLAND
| | - Hanna Lauren
- Department of Radiology, Helsinki University Central Hospital Comprehensive Cancer Center, Haartmaninkatu 4, Helsinki, Uusimaa, 00029, FINLAND
| | - Kirsti Numminen
- Department of Radiology, Meilahti Hospital, Haartmaninkatu 4, Helsinki, Uusimaa, 00029, FINLAND
| | - Harri Sievänen
- R&D Department, Injeq, Biokatu 8, Tampere, 33520, FINLAND
| | - Jari Hyttinen
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, Tampere, Pirkanmaa, 33520, FINLAND
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Nguyen DM, Duong Trong L, McEwan AL. An efficient and fast multi-band focused bioimpedance solution with EIT-based reconstruction for pulmonary embolism assessment: a simulation study from massive to segmental blockage. Physiol Meas 2022; 43. [PMID: 34986471 DOI: 10.1088/1361-6579/ac4830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 01/05/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Pulmonary embolism (PE) is an acute condition that blocks the perfusion to the lungs and is a common complication of Covid-19. However, PE is often not diagnosed in time, especially in the pandemic time due to complicated diagnosis protocol. In this study, a non-invasive, fast and efficient bioimpedance method with the EIT-based reconstruction approach is proposed to assess the lung perfusion reliably. APPROACH Some proposals are presented to improve the sensitivity and accuracy for the bioimpedance method: (1) a new electrode configuration and focused pattern to help study deep changes caused by PE within each lung field separately, (2) a measurement strategy to compensate the effect of different boundary shapes and varied respiratory conditions on the perfusion signals and (3) an estimator to predict the lung perfusion capacity, from which the severity of PE can be assessed. The proposals were tested on the first-time simulation of PE events at different locations and degrees from segmental blockages to massive blockages. Different object boundary shapes and varied respiratory conditions were included in the simulation to represent for different populations in real measurements. RESULTS The correlation between the estimator and the perfusion was very promising (R = 0.91, errors < 6%). The measurement strategy with the proposed configuration and pattern has helped stabilize the estimator to non-perfusion factors such as the boundary shapes and varied respiration conditions (3-5% errors). SIGNIFICANCE This promising preliminary result has demonstrated the proposed bioimpedance method's capability and feasibility, and might start a new direction for this application.
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Affiliation(s)
- Duc Minh Nguyen
- School of Biomedical Engineering, University of Sydney - Camperdown and Darlington Campus SciTech Library, Room 415, Level 4, Link Building Faculty of Engineering and IT, The University of Sydney, Darlington, Hanoi, New South Wales, 100000, AUSTRALIA
| | - Luong Duong Trong
- School of Electronics and Telecommunication, Hanoi University of Science and Technology, No. 1, Dai Co Viet Street, Hai Ba Trung District, Hanoi, 100000, VIET NAM
| | - Alistair L McEwan
- School of Biomedical Engineering, The University of Sydney, Room 415, Level 4, Link Building Faculty of Engineering and IT, The University of Sydney, Darlington NSW 2006, Australia, Sydney, New South Wales, 2006, AUSTRALIA
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Marinier MC, Ogunsola AS, Elkins JM. Body Composition Changes in the Immediate Peri-operative Period Following Total Joint Arthroplasty. J Electr Bioimpedance 2022; 13:39-44. [PMID: 36196241 PMCID: PMC9487908 DOI: 10.2478/joeb-2022-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/26/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Bioimpedance analysis (BIA) is a readily available tool to assess body composition in a clinical setting. BIA has received little attention in orthopaedics and namely joint arthroplasty. This study aims to quantify changes in body composition in the immediate peri-operative period following total joint arthroplasty. METHODS Adults scheduled for elective total joint arthroplasty were recruited to participate. Patients underwent BIA scans in the immediate peri-operative period: pre-operative on their day of surgery, post-operative day 0, and post-operative day 1. RESULTS 67 patients were enrolled to undergo BIA scans. Mean age was 62.64 ± 10.28 years old, and 49.2% were females. The all-supine cohort exhibited a 0.36 ± 0.61 kg increase in dry lean mass (p < 0.001) and 1.30 ± 2.14 kg increase in lean body mass on postoperative day 0 (p < 0.001). Patients received to 1.16 ± 0.58 kg of fluid mass, on average. CONCLUSION BIA is a rapid, portable tool that allows for body composition analysis of an inpatient surgical population. This study demonstrated that BIA can detect net fluid changes and may approximate implant mass following total joint arthroplasty. This may aid surgeons in interpreting post-operative body composition changes.
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Affiliation(s)
- Michael C. Marinier
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IAUSA
| | - Ayobami S. Ogunsola
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IAUSA
| | - Jacob M. Elkins
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IAUSA
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Schwarz CE, Livingstone V, O'Toole JM, Healy DB, Panaviene J, Dempsey EM. Agreement of Cardiac Output Estimates between Electrical Cardiometry and Transthoracic Echocardiography in Very Preterm Infants. Neonatology 2022; 119:594-601. [PMID: 35896077 DOI: 10.1159/000525755] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/22/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The aim was to evaluate the agreement between cardiac output estimates obtained by electrical cardiometry (EC) and transthoracic echocardiography (TTE) in very preterm infants. METHODS This is a single-center prospective observational study in infants born<32 weeks gestational age within 48 h of birth. Continuous EC was recorded and simultaneous TTE obtained on day 1 and day 2 of life. Blinded TTE measurements were performed within a 10 s timeframe using beat-to-beat EC data. The primary outcome was %error of left ventricular (LV) output in milliliters per kilogram per minute (cardiac index (CI)) obtained by TTE compared to LV-CI from EC. Secondary outcome parameters were bias, %bias, limits of agreement and include measures of right ventricular (RV) output and LV systolic time intervals. RESULTS Analysis was performed for 34 infants (median (IQR) gestational age 29 + 0 (24 + 5 to 30 + 6) weeks + days, birthweight 960 (748 to 1,490) grams) including 44 pairwise LV output measurements on 24 participants (22 on day 1 and day 2). The %error was 54% for LV-CI (EC: 214 (38) mL/kg/min vs. TTE: 163 (47) mL/kg/min). The %error was 78% for RV-CI (EC: 213 (37) mL/kg/min vs. TTE: 241 (77) mL/kg/min). While only LV-CI values affected LV-CI bias, signal quality, heart rate, and RV-CI values affected RV-CI bias. CONCLUSION EC is not interchangeable with TTE to estimate indices of LV or RV output in very preterm infants within the first 48 h postnatally. EC may not measure LV output distinctly in very preterm infants with intra- and extracardiac shunts.
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Affiliation(s)
- Christoph E Schwarz
- Department of Paediatrics & Child Health, University College Cork, Cork, Ireland.,INFANT Research Centre, University College Cork, Cork, Ireland.,Department of Neonatology, University Children's Hospital Tübingen, Tübingen, Germany
| | - Vicki Livingstone
- Department of Paediatrics & Child Health, University College Cork, Cork, Ireland.,INFANT Research Centre, University College Cork, Cork, Ireland
| | - John M O'Toole
- Department of Paediatrics & Child Health, University College Cork, Cork, Ireland.,INFANT Research Centre, University College Cork, Cork, Ireland
| | - David B Healy
- Department of Paediatrics & Child Health, University College Cork, Cork, Ireland
| | - Jurate Panaviene
- Department of Paediatrics & Child Health, University College Cork, Cork, Ireland.,INFANT Research Centre, University College Cork, Cork, Ireland
| | - Eugene M Dempsey
- Department of Paediatrics & Child Health, University College Cork, Cork, Ireland.,INFANT Research Centre, University College Cork, Cork, Ireland
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Hernández-Salinas CA, Corzo-Cruz A, Sánchez-Monroy V, Munguía-Cervantes JE, González-Díaz CA. Correlation of the DNA Concentration of Human Samples to Electrical Bioimpedance Measurements: A Pilot Study. J Electr Bioimpedance 2022; 13:132-135. [PMID: 36694879 PMCID: PMC9837867 DOI: 10.2478/joeb-2022-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Indexed: 06/17/2023]
Abstract
It is necessary to evaluate the total deoxyribonucleic acid (DNA) concentration in gene expression assays. The existing techniques require equipment that is expensive for many labs in developing countries. Portable and inexpensive equipment is needed for easy and economical DNA quantification. Electrical bioimpedance spectroscopy (EBiS) is a non-invasive and inexpensive technique for examining the electrical properties of biological materials. The aim of this study was to explore a potential correlation between the measurement of total DNA extracted from human samples by UV-Vis spectrophotometry and EBiS. Hence, after quantifying the total DNA extracted from each sample by UV-Vis spectroscopy, EBiS was recorded and a possible correlation between the two measurements was analyzed. Considering the bioimpedance phase parameter at 5.24 MHz, a significant correlation was found with total DNA, especially when the concentration was below 100 ng/μL (Spearman coefficient = 0.82, p<0.005). Additional experiments are warranted to confirm these findings.
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Affiliation(s)
| | - Alejandro Corzo-Cruz
- Centro Militar de Ciencias de la Salud – Escuela Militar de Graduados de Sanidad, UDEFA, CDMX, México
- Instituto Politécnico Nacional – Escuela Superior de Medicina, CDMX, México
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Beligaswatta C, Sudusinghe D, De Silva S, Davenport A. Prevalence and correlates of low plasma selenium concentrations in peritoneal dialysis patients. J Trace Elem Med Biol 2022; 69:126899. [PMID: 34798513 DOI: 10.1016/j.jtemb.2021.126899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 10/09/2021] [Accepted: 11/04/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Selenium is a key component in multiple enzyme systems, and dialysis patients with lower levels have been reported to have increased mortality. Low selenium levels were commonly reported in historic hemodialysis patients, but not in recent studies. There have been very few studies in peritoneal dialysis (PD) patients, and with the increasing age and frailty of our PD population we wished to review factors associated with lower selenium in PD patients. DESIGN & METHODS We retrospectively reviewed plasma selenium, normal laboratory >0.8 umol/L, measurements from a cohort of PD patients, attending for routine peritoneal membrane assessments, along with measurement of dialysis adequacy (Kt/Vurea), and normalized nitrogen appearance rate (nPNA) and bioimpedance measured extracellular water (ECW)/total body water (TBW), and skeletal muscle mass indexed for height (SMMI). RESULTS The median plasma selenium was 0.84 (IQR-0.72-1.01) umol/L in 406 PD patients, 61.1 % male, mean age 59.0 ± 15.5 years, 44.9 % diabetic with 15.8 % designated as clinically frail (CFS). 41.4 % had selenium deficiency (<0.8 umol/L), and was more common with increasing CFS (χ2-6.8, p < 0.009), comorbidity grade(χ2-26.74, p < 0.001).Plasma selenium correlated with serum total protein (TP) (r = 0.352), albumin (r = 0.358), nPNA (r = 0.263), and negatively with ECW/TBW (r= -0.321) all p < 0.001, and positively with SMMI (rho = 0.109, p = 0.03). On multivariable analysis selenium was independently associated with TP (β 0.799 ± 0.15,95 % confidence limits (95CL) (0.505-1.093), p=<0.001), and negatively with C reactive protein (CRP) (β -0.02 ± 0.01, (95CL -0.047 to -0.005) p = 0.01), and ECW/TBW (β -1.499 ± 0.42 (95CL -2.33 to -0.666) p=<0.001). CONCLUSIONS Compared to recent studies in hemodialysis patients, we report a 41 % prevalence for low selenium levels. Plasma selenium was positively associated with total serum protein, and negatively with CRP and ECW/TBW. Thus, lower selenium concentrations were linked to reduced dietary protein intake, and increasing frailty, inflammation and ECW/TBW ratios.
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Affiliation(s)
| | | | - Sinha De Silva
- Post Graduate Institute of Medicine, Colombo, Sri Lanka.
| | - Andrew Davenport
- UCL Department of Nephrology, Royal Free Hospital, University College London, London, UK.
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Aukrust Å, Foseid LM, Holm K. Development of a Small Footprint Device for Measuring Electrodermal Activity in the Palm of the Hand. J Electr Bioimpedance 2022; 13:150-155. [PMID: 36699665 PMCID: PMC9837872 DOI: 10.2478/joeb-2022-0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Indexed: 06/17/2023]
Abstract
This paper describes the proof of concept for a wearable device that measures skin conductance, to provide a way of quantifying an individual's physiological stress response to external stimuli. Important goals of the project were to have reliable measurements that correlate with the external stimuli, as well as a small footprint and low power consumption to facilitate battery powered operation. These goals were accomplished using a STM32L476 micro-controller to generate an AC sine voltage across two solid gel electrodes placed in the palm of the hand, converting the resulting current to a voltage with a trans-impedance amplifier, which was then sampled and processed digitally in a lock-in amplifier, to eliminate signals differing from the desired (reference) frequency and phase. The output of the lock-in amplifier represents the skin conductance and was transmitted over USB to a computer with software for serial capture.
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Affiliation(s)
- Åsmund Aukrust
- Department of Clinical and Biomedical Engineering, Oslo University Hospital, Oslo, Norway
| | - Leah Marie Foseid
- Department of Clinical and Biomedical Engineering, Oslo University Hospital, Oslo, Norway
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Savostyanov V, Kobelev A, Kudashov I. Comprehensive Biotechnical System for Screening Risk-based Diagnosis of COVID-19 and Post-COVID Syndrome. J Electr Bioimpedance 2022; 13:45-53. [PMID: 36196240 PMCID: PMC9487909 DOI: 10.2478/joeb-2022-0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/26/2022] [Indexed: 06/16/2023]
Abstract
At present, there are no hardware or biochemical systems that allow to assess the severity of post-COVID syndrome in vivo. The hardware of the proposed biotechnical system is based on routine transthoracic electrical impedance rheography, which makes it possible to register the frequency characteristics of the patient's bioimpedance response to controlled stress stimulation, thereby simultaneously fixing the characteristics of his productive heart, the state of the hemomicrocirculatory bed, the efficiency of the gas transport function of his blood, and also reliably assess personal reactivity and adaptive potential. Subsequent mathematical approximation of the obtained biometric data by an original neural network makes it possible to rank the results obtained and automatically generate a program of medical rehabilitation for a particular patient, depending on the severity of his post-COVID syndrome. The study results proved two reliable physiological signs confirming the presence of latent post-COVID complications: a decrease in the base impedance value for light exercise and an increase in the length of the systolic arc of the rheocardiogram.
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Affiliation(s)
- Vladimir Savostyanov
- Faculty of Biomedical Engineering, Bauman Moscow State Technical University, Moscow, Russia
| | - Alexander Kobelev
- Faculty of Biomedical Engineering, Bauman Moscow State Technical University, Moscow, Russia
| | - Ivan Kudashov
- Faculty of Biomedical Engineering, Bauman Moscow State Technical University, Moscow, Russia
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Osen DE, Abie SM, Martinsen ØG, Egelandsdal B, Münch D. Bioimpedance-based Authentication of Defrosted Versus Fresh Pork at the End of Refrigerated Shelf Life. J Electr Bioimpedance 2022; 13:125-131. [PMID: 36699663 PMCID: PMC9837875 DOI: 10.2478/joeb-2022-0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Indexed: 06/17/2023]
Abstract
Correct food labeling is a legal requirement and helps consumers to make informed purchasing choices. Mislabeling defrosted meat as fresh is illegal in the EU. However, there are no standardized technologies to authenticate fresh versus defrosted meat. We address this by testing if bioimpedance-based measurements can separate defrosted meat from refrigerated-only meat at the end of shelf life, i.e., when also fresh meat shows deterioration. Pork sirloin samples from 20 pigs were first tested at 12 days postmortem ('fresh group'). This time point was chosen to represent a typical use-by date for refrigerated storage of fresh pork. Then, all samples were transferred to a -24°C freezer for 3 days and thawed for 2 days before final testing ('frozen-thawed group'). Bioimpedance analyses (BIA) were done in a frequency range of [102-106 Hz]. Weight, pH and electrode positioning were assessed to test for potential confounding effects. Statistics for treatment dependent differences were based on the established Py parameter and phase angle, which were extracted from the BI spectra. We found that using bioimpedance testing with tetrapolar electrodes, Py and phase angle allowed almost complete separation of fresh and previously frozen samples. However, within the whole sample population, there was some overlap between the spectra of fresh and frozen samples. Yet, based on Py, only one fresh sample (5% of Ntotal=20) fell in the lowest Py class with all the frozen samples. We used a multifactorial design that allowed to test the effects of potential confounding factors, such as electrode positioning and meat quality parameters. We found a relatively low explained variance for the Py parameter, indicating that confounding effects from other factors or quality defects in fresh pork may affect the detection capacity of bioimpedance-based authentication of fresh pork. Our data, therefore, suggest that reliable fresh-label authentication with bioimpedance testing should be based on testing a small number of samples to represent a specific lot of pork that is to be inspected.
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Affiliation(s)
- Daniel E. Osen
- Department of Physics, University of Oslo, 0316Oslo, Norway
| | - Sisay Mebre Abie
- Department of Physics, University of Oslo, 0316Oslo, Norway
- Faculty of Ecology and Natural Resource Management, Norwegian University of Life Sciences, 1432 Ås, Oslo, Norway
| | - Ørjan G. Martinsen
- Department of Physics, University of Oslo, 0316Oslo, Norway
- Department of Clinical and Biomedical Engineering, Oslo University Hospital, 0372Oslo, Norway
| | - Bjørg Egelandsdal
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, 1432 Ås, Oslo, Norway
| | - Daniel Münch
- Animalia, Norwegian Meat and Poultry Research Center, 0513Oslo, Norway
- Faculty of Ecology and Natural Resource Management, Norwegian University of Life Sciences, 1432 Ås, Oslo, Norway
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Duong Trong L, Nguyen Quang L, Hoang Anh D, Dang Tuan D, Nguyen Chi H, Nguyen Minh D. A Portable Band-shaped Bioimpedance System to Monitor the Body Fat and Fasting Glucose Level. J Electr Bioimpedance 2022; 13:54-65. [PMID: 36479359 PMCID: PMC9709820 DOI: 10.2478/joeb-2022-0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Indexed: 06/17/2023]
Abstract
With better quality of life, obesity is becoming a worldwide disease due to over-eating and sedentary lifestyle. Therefore, daily monitoring of the glucose and body fat percentage (%) is vital to keep track of one's health. Currently, separated devices are required to monitor each parameter at home and some are still invasive to measure the glucose level. In this study, a portable band-shaped bioimpedance system is proposed to measure both parameters. The system is battery run with two main modules: the current source and the voltage recording, with minimal design to fit into a band of 150 mm x 40 mm in dimension. The impedance is measured at the frequency of 1 kHz at 30 kHz sampling frequency and in 1000 signal cycles to flatten noises. The final average impedance is calculated and evaluated in correlation with the body fat and the fasting glucose. The system was tested on 21 volunteers and 4 locations were picked for the impedance measurement: the arm under the triceps, the side of the belly, the back on one side and the thigh under the bicep femoris. The results show promising results with the arm being the best location for predicting the body fat (correlation coefficient: 0.89, 95% CI: 0.73-0.95), while the thigh impedance best correlated with the fasting glucose (correlation coefficient: 0.92, 95% CI: 0.81-0.97). These preliminary results indicate the feasibility and capacity of the proposed system as a home-based, portable and convenient system in monitoring the body fat and glucose. The system's performance will be verified and replicated in a future larger study.
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Affiliation(s)
- Luong Duong Trong
- School of Electrical and Electronics Engineering, Hanoi University of Science and Technology, Hanoi, Vietnam
| | - Linh Nguyen Quang
- School of Electrical and Electronics Engineering, Hanoi University of Science and Technology, Hanoi, Vietnam
| | - Duc Hoang Anh
- School of Electrical and Electronics Engineering, Hanoi University of Science and Technology, Hanoi, Vietnam
| | - Diep Dang Tuan
- School of Electrical and Electronics Engineering, Hanoi University of Science and Technology, Hanoi, Vietnam
| | - Hieu Nguyen Chi
- School of Electrical and Electronics Engineering, Hanoi University of Science and Technology, Hanoi, Vietnam
| | - Duc Nguyen Minh
- School of Electrical and Electronics Engineering, Hanoi University of Science and Technology, Hanoi, Vietnam
- School of Biomedical Engineering, University of Sydney, NSW, Australia
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Gomes TLM, Peixoto MVM, de Azevedo ZMA, Fonseca VM, Ramos EG. Association of electrical bioimpedance vectors with the nutritional classification of vulnerable multiethnic children. Clin Nutr ESPEN 2021; 46:453-458. [PMID: 34857233 DOI: 10.1016/j.clnesp.2021.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/06/2021] [Accepted: 09/15/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND & AIMS Monitoring growth and body composition in childhood is vital for early detection of health and nutrition problems during child development. The bioelectrical impedance vector analysis (BIVA) revealed its effectiveness as an indicator of nutritional status. This study aimed to measure the bioimpedance vectors of a sample of multiethnic children and evaluate the utility of BIVA for the classification of the nutritional status in a group of children with greater vulnerability, including in the presence of obesity. METHODS This is a cross-sectional study that analyzed the bioelectrical impedance of a sample of 321 children from public daycare centers, aged 1-4 years, using the RXc graph method (tetrapolar analysis at 50 kHz frequency). The 95%, 75%, and 50% tolerance ellipses were plotted by age group. The Z-scores of bioimpedance parameters (Xc/H-Z and R/H-Z) were calculated regarding age, which were used to build reference tolerance ellipses for a single group, regardless of age. Such ellipses were evaluated for their ability to recognize the pattern and classify the deviations, using individual vectors of obese children. RESULTS The mean impedance vectors showed progressively higher reactances and lower resistances with age. In the group of obese children, the individual vectors located outside the 95% baseline tolerance ellipse were 12.5%, 18.75%, and 11.1% of the cases for the WHZ, WAZ, and BMIZ criteria, respectively, all above the expected 5%, but much below expectations. This may be a problem with the obesity criteria used, as WHZ, WAZ, and BMIZ do not differentiate fat from lean mass. CONCLUSION Bioimpedance vector analysis reflects differences in the bioelectric patterns of children classified as obese. Provided the obesity criteria are constructed based on fat measurements, rather than lean mass, the use of tolerance ellipses in the BIVA chart is promising as a tool for monitoring nutritional status where measuring body composition is difficult, because constant tissue hydration cannot be assumed.
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Affiliation(s)
- Taisa Lisboa Montagner Gomes
- Department of Education and Research, Instituto Federal de Educação, Ciência e Tecnologia do Maranhão, São Luís, Brazil.
| | - Maria Virginia Marques Peixoto
- Analytical Methods Laboratory, Research Department, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Zina Maria Almeida de Azevedo
- Intensive Care Unit, Pediatrics Department, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Vania Matos Fonseca
- Clinical Research Unit, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Eloane Gonçalves Ramos
- Clinical Research Unit, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
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45
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Oshin EA, Guo S, Jiang C. Determining tissue conductivity in tissue ablation by nanosecond pulsed electric fields. Bioelectrochemistry 2021; 143:107949. [PMID: 34583212 PMCID: PMC8643318 DOI: 10.1016/j.bioelechem.2021.107949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 09/10/2021] [Accepted: 09/15/2021] [Indexed: 02/03/2023]
Abstract
Nanosecond pulsed electric field (nsPEF) causes the permeabilization of the cell membrane and has been used to non-thermally treat cancerous tissues. As increased permeabilization in membranes were reported to be accompanied by impedance changes, the ablation effect of nsPEF on tissues can be monitored via the changes in tissue conductivity. In this study, effects of nsPEF on biological tissues were evaluated by determining the conductivities of potato and 4 T1-luc breast tumor tissues ex vivo from a murine model subjected to multiple 100-ns, 1-10 kV pulses. Using a four-needle electrode system with a calibrated electrode constant of 1.1 ± 0.1 cm, the conductivities of tissues was determined from both the network-analyzer measurement, before and after treatment, and voltage-current measurement in real-time. The conductivity of the potato tissue was measured for a frequency range of 0.1-3 MHz, and it increased with increasing pulse number and voltage amplitude. The conductivity of the tumor tissue was also observed to increase with pulse number and pulse voltage over a similar frequency range. In addition, the linear correlation between the ablation area in a treated potato tissue and the conductivity change in the tissue suggests that conductivity analysis of biological tissue under treatment could be a fast and sensitive approach to evaluate the effectiveness of a nsPEF treatment.
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Affiliation(s)
- Edwin A. Oshin
- Frank Reidy Research Center for Bioelectrics, Old Dominion University, Norfolk, VA, USA,Department of Electrical and Computer Engineering, Old Dominion University, Norfolk, VA, USA
| | - Siqi Guo
- Frank Reidy Research Center for Bioelectrics, Old Dominion University, Norfolk, VA, USA
| | - Chunqi Jiang
- Frank Reidy Research Center for Bioelectrics, Old Dominion University, Norfolk, VA, USA,Department of Electrical and Computer Engineering, Old Dominion University, Norfolk, VA, USA
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Abstract
Objective: Bioimpedance sensing is a powerful technique that measures the tissue impedance and captures important physiological parameters including blood flow, lung movements, muscle contractions, body fluid shifts, and other cardiovascular parameters. This paper presents a comprehensive analysis of the modality at different arterial (ulnar, radial, tibial, and carotid arteries) and thoracic (side-rib cage and top thoracolumbar fascia) body regions and offers insights into the effectiveness of capturing various cardiac and respiratory activities. Methods: We assess the bioimpedance performance in estimating inter-beat (IBI) and inter -breath intervals (IBrI) on six-hours of data acquired in a pilot-study from five healthy participants at rest. Results: Overall, we achieve mean errors as low as 0.003 ± 0.002 and 0.67 ± 0.28 seconds for IBI and IBrI estimations, respectively. Conclusions: The results show that bioimpedance can be effectively used to monitor cardiac and respiratory activities both at limbs and upper body and demonstrate a strong potential to be adopted by wearables that aim to provide high-fidelity physiological sensing to address precision medicine needs.
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Affiliation(s)
- Kaan Sel
- Texas A&M University, College Station, TX 77843 USA
| | - Deen Osman
- Texas A&M University, College Station, TX 77843 USA
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Akiyama Y, Matsuoka R, Masuda T, Iwamoto S, Sugie S, Muto T, Miyamoto Y, Ohdate T, Nakagawa S, Okada M, Imai T, Komada T, Suzuki M, Maeshima A, Akimoto T, Saito O, Nagata D. Comparative Impact of Isolated Ultrafiltration and Hemodialysis on Fluid Distribution: A Bioimpedance Study. Blood Purif 2021; 51:492-502. [PMID: 34515071 DOI: 10.1159/000518228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 06/29/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Isolated ultrafiltration (IUF) is an alternative treatment for diuretic-resistant patients with fluid retention. Although hemodialysis (HD) predominantly decreases extracellular water (ECW), the impact of IUF on fluid distribution compared with HD remains unclear. METHODS We compared the effect of HD (n = 22) and IUF (n = 10) sessions on the body fluid status using a bioimpedance analysis device (InBody S10). RESULTS The total ultrafiltration volume was similar between HD and IUF (HD 2.5 ± 0.3 vs. ICF 2.1 ± 0.3 L/session, p = 0.196). The reduction rate of ECW was significantly higher than that of intracellular water (ICW) after HD (ECW -7.9% ± 0.8% vs. ICW -3.0% ± 0.9%, p < 0.001) and IUF (ECW -5.8% ± 0.9% vs. ICW -3.6% ± 0.8%, p = 0.048). However, the change in the ratio of ECW to total body water in HD was significantly larger than that in IUF (HD -3.2% ± 0.3% vs. ICF -1.1% ± 0.4%, p < 0.001). The reduction rates in serum tonicity (effective osmolality) were higher after HD than after IUF (HD -1.8% ± 0.5% vs. IUF -0.6% ± 0.2%, p = 0.052). Among the components of effective osmolality, the reduction rates of serum K+ and glucose levels after HD were significantly higher than those after IUF (serum K+: HD -30.5% ± 1.6% vs. IUF -0.5% ± 3.8%, p < 0.001; serum glucose: HD -15.4% ± 5.0% vs. IUF 0.7% ± 4.8%, p = 0.026), while the serum Na+ level was slightly and similarly reduced (HD -0.8% ± 0.4% vs. IUF -0.8% ± 0.4%, p = 0.500). The reduction in the osmolal gap value (measured osmolality-calculated osmolarity) was significantly greater after HD sessions than after IUF sessions (HD -12.4 ± 1.4 vs. IUF 2.0 ± 1.0 mOsm/kg, p = 0.001). CONCLUSION The extracellular fluid reduction effect of HD is stronger than that of IUF. The different changes in effective osmolality and osmolal gap after HD and IUF sessions may be related to the different effects of HD and IUF on fluid distribution.
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Affiliation(s)
- Yuki Akiyama
- Department of Clinical Engineering, Jichi Medical University, Tochigi, Japan
| | - Ryo Matsuoka
- Department of Clinical Engineering, Jichi Medical University, Tochigi, Japan
| | - Takahiro Masuda
- Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan
| | - Sumiya Iwamoto
- Department of Clinical Engineering, Jichi Medical University, Tochigi, Japan
| | - Shun Sugie
- Department of Clinical Engineering, Jichi Medical University, Tochigi, Japan
| | - Takafumi Muto
- Department of Clinical Engineering, Jichi Medical University, Tochigi, Japan
| | - Yuka Miyamoto
- Department of Clinical Engineering, Jichi Medical University, Tochigi, Japan
| | - Takayuki Ohdate
- Department of Clinical Engineering, Jichi Medical University, Tochigi, Japan
| | - Saki Nakagawa
- Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan
| | - Mari Okada
- Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan
| | - Toshimi Imai
- Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan
| | - Takanori Komada
- Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan
| | - Michiko Suzuki
- Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan
| | - Akito Maeshima
- Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan
| | - Tetsu Akimoto
- Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan
| | - Osamu Saito
- Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan
| | - Daisuke Nagata
- Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan
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Mundstock E, Vendrusculo FM, Filho AD, Mattiello R. Consuming a low-calorie amount of routine food and drink does not affect bioimpedance body fat percentage in healthy individuals. Nutrition 2021; 91-92:111426. [PMID: 34450384 DOI: 10.1016/j.nut.2021.111426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 06/29/2021] [Accepted: 07/15/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Bioimpedance analysis is a simple, safe, and relatively inexpensive method to assess body composition. The bioimpedance guidelines recommend that the test be performed after fasting and avoiding the consumption of liquids. Studies have verified the effects of consuming liquids and food on bioimpedance; however, these studies used preestablished meals and hydration. The aim of the present study is to identify whether ad libitum food and liquid intake interfere with body composition parameters estimated via bioimpedance. METHODS The evaluations were carried out over 2 d. On the first d, the hydration protocol was applied and on the second d, the food protocol. In both cases, bioimpedance was performed after an 8-h overnight fast. The test was repeated 30 min after the intake of liquids or food depending on the protocol. The reproducibility between the pre- and posttest evaluations was assessed using the Bland-Altman method. We considered deviations of up to 5% in the limits of agreement to be clinically acceptable. RESULTS In the hydration protocol, the mean difference in fat percentage (FP) was -0.50 (P = 0.05), the lower limit of agreement was -3.60%, and the upper limit of agreement was 2.61%. In the food protocol, the mean difference in FP was 0.002 (P = 0.99), the lower limit of agreement was -3.20%, and the upper limit of agreement was 3.20%. CONCLUSIONS Our study shows that ad libitum food and liquid intake do not cause a change above clinically acceptable levels in the FP estimated by bioimpedance.
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Affiliation(s)
- Eduardo Mundstock
- Pontifícia Universidade Católica do Rio Grande do Sul, Brazil. Departamento de Desporto Escolar, Secretaria de Educação, Esporte e Lazer de Canela/RS, Brazil
| | | | | | - Rita Mattiello
- Pontifícia Universidade Católica do Rio Grande do Sul, Brazil.
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Gautier N, Sampol J, Zagdoun E, Duquennoy S, Dione DJP, Edet S, Lobbedez T, Ficheux M. What Total Body Water Measurement Should Be Used for Prescribing the Dialysis Dose in Low-Flow Home Daily Dialysis? Blood Purif 2021; 51:540-547. [PMID: 34404044 DOI: 10.1159/000517815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 06/13/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION In low-flow home daily dialysis (HDD), the dialysis dose is evaluated from the total body water (TBW). TBW can be estimated by anthropometric methods or bioimpedance spectroscopy. METHODS A multicentric cross-sectional study of patients in HDD for >3 months was conducted to assess the correlation and the difference between the anthropometric estimate of TBW (Watson-TBW) and the bioimpedance estimate (BIS-TBW) and to analyse the impact on the dialysate volume prescribed. RESULTS Forty patients from 10 centres were included. The median BIS-TBW and Watson-TBW were 35.1 (29.1-41.4 L) and 36.9 (32-42.4 L), respectively. The 2 methods had a good correlation (r = 0.87, p < 0.05). However, Bland-Altman analysis showed an overestimation of TBW with Watson's formula, with a bias of 2.77 L. For 4, 5, or 6 sessions per week, the use of Watson-TBW increases the dialysate prescription per week by 100 L, 45 L, or 10 L, respectively, over our entire cohort. There is no increase in the volume of dialysate prescribed with the 7 sessions per week schedule. CONCLUSION BIS-TBW and Watson-TBW estimation have a good correlation; however, Watson's equation overestimates TBW. This overestimation is negligible for a prescription frequency of >5 sessions per week.
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Affiliation(s)
- Nicolas Gautier
- Néphrologie, CHU de Caen Normandie, Caen, France.,ANIDER, Caen, France
| | - Jerome Sampol
- Phocean Nephrology Institute, Clinique Bouchard, Elsan, Marseille, France.,Association pour le Traitement des Urémiques en Provence, Marseille, France
| | | | | | | | | | - Thierry Lobbedez
- Néphrologie, CHU de Caen Normandie, Caen, France.,U1086 INSERM - ANTICIPE, Centre Régional de Lutte contre le Cancer François Baclesse, Caen, France.,Université Caen Normandie - UFR de médecine (Medical School), Caen, France
| | - Maxence Ficheux
- Néphrologie, CHU de Caen Normandie, Caen, France.,ANIDER, Caen, France
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50
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Salazar G, Leyton B, Aguirre C, Anziani A, Weisstaub G, Corvalán C. Anthropometric and bioimpedance equations for fat and fat-free mass in Chilean children 7-9 years of age. Br J Nutr 2021; 126:37-42. [PMID: 33028443 DOI: 10.1017/S0007114520003906] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Assessing children's growth adequately is important due to the necessary prevention of adequate body composition, especially at pre-pubertal age. Simpler measurements such as anthropometry or bioimpedance, using equations validated in Caucasian children, have been demonstrated to overestimate or underestimate fat mass percentage (FM%) or fat-free mass (FFM) in Chilean children. In a sample of 424 children (198 boys and 226 girls) of 7-9 years old, the three component (3C) model was assessed, where total body water was determined by 2H dilution and body volume by air displacement plethysmography, in order to design and validate anthropometry and bioimpedance equations. The FM (%) equation specific for Chilean children was validated as (1·743 × BMI z-score) + (0·727 × triceps skinfold) + (0·385 × biceps skinfold) + 15·985, against the 3C model (R2 0·79). The new FFM equation (kg) generated was (log FFM = (0·018 × age) + (0·047 × sex) + (0·006 × weight) + (0·027 × resistance) + 2·071), with an R2 0·93 (female = 1 and male = 2). The Bland-Altman analysis shows a mean difference of 0·27 (sd 3·5) for the FM% in the whole group as well as 0·004 (sd 0·9) kg is the mean difference for the bioelectrical impedance analysis (BIA) FFM (kg) equation. The new equations for FM (%) and FFM (kg) in Chilean children will provide a simple and valid tool for the assessment of body composition in cohort studies or to assess the impact of nutritional programmes or public policies.
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