The association of hydration status with physical signs, symptoms and survival in advanced cancer-The use of Bioelectrical Impedance Vector Analysis (BIVA) technology to evaluate fluid volume in palliative care: An observational study

Background Hydration in advanced cancer is a controversial area; however, current hydration assessments methods are poorly developed. Bioelectrical impedance vector analysis (BIVA) is an accurate hydration tool; however its application in advanced cancer has not been explored. This study used BIVA to evaluate hydration status in advanced cancer to examine the association of fluid status with symptoms, physical signs, renal biochemical measures and survival. Materials and methods An observational study of 90 adults with advanced cancer receiving care in a UK specialist palliative care inpatient unit was conducted. Hydration status was assessed using BIVA in addition to assessments of symptoms, physical signs, performance status, renal biochemical measures, oral fluid intake and medications. The association of clinical variables with hydration was evaluated using regression analysis. A survival analysis was conducted to examine the influence of hydration status and renal failure. Results The hydration status of participants was normal in 43 (47.8%), 'more hydrated' in 37 (41.1%) and 'less hydrated' in 10 (11.1%). Lower hydration was associated with increased symptom intensity (Beta = -0.29, p = 0.04) and higher scores for physical signs associated with dehydration (Beta = 10.94, p = 0.02). Higher hydration was associated with oedema (Beta = 2.55, p<0.001). Median survival was statistically significantly shorter in 'less hydrated' patients (44 vs. 68 days; p = 0.049) and in pre-renal failure (44 vs. 100 days; p = 0.003). Conclusions In advanced cancer, hydration status was associated with clinical signs and symptoms. Hydration status and pre-renal failure were independent predictors of survival. Further studies can establish the utility of BIVA as a standardised hydration assessment tool and explore its potential research application, in order to inform the clinical management of fluid balance in patients with advanced cancer

Detecting cocaine use? The autobiographical implicit association test (aIAT) produces false positives in a real-world setting.

The aIAT is a variant of an attitude measure and can be better rationalized if propositional thinking is implied to explain outcomes. The Relational Frame and Social Knowledge Structure theories can perhaps provide a more plausible theoretical background. Further work is required to clarify which factors underlie this testing technique's functioning. Reappraisal is advised before further forensic use of the instrument to ensure that general associations not related to autobiographical memory do not confound results

Combined evaluation of nutrition and hydration in dialysis patients with bioelectrical impedance vector analysis (BIVA).

Abstract BACKGROUND & AIMS: Body hydration changes continuously in hemodialysis patients. The Subjective Global Assessment (SGA) is used for the nutritional evaluation but it does not allow a direct evaluation of hydration. Bioelectrical impedance vector analysis (BIVA) is very sensitive to hydration. The potential of the combined evaluation of hydration and nutrition with SGA and BIVA is still lacking. METHODS: Observational cross-sectional study on 130 (94 Male) uremic patients undergoing chronic hemodialysis three times a week. Nutritional status was evaluated with the SGA. Each subject was classified as SGA-A (normal nutritional status), SGA-B (moderate malnutrition), or SGA-C (severe malnutrition). Body hydration was evaluated with BIVA. The two vector components resistance (R) and reactance (Xc) were normalized by the subject's height and standardized as bivariate Z-score, i.e. Z(R) and Z(Xc). RESULTS: Undernutrition influenced impedance vector distribution both before and after a dialysis session. In pre-dialysis, the mean vector of SGA A was inside the 50% tolerance ellipse. In SGA B and C, Z(R) was increased and Z(Xc) decreased, indicating a progressive loss of soft tissue mass. Fluid removal with dialysis increased both Z(R) and Z(Xc) in SGA A and B but not in C. With ROC curve analysis on the slope of increase, we found the cutoff value of 27.8\ub0 below which undernutrition was present, either moderate or severe. The area under the ROC curve was 77.7\ub0 (95% CI 69.5-84.5, P < .0001) with sensitivity 75.9%, specificity 78.6%, positive predicted value 74.6%, and negative predicted value 79%. CONCLUSIONS: The distribution of impedance vectors is associated with the SGA classification of patients. The change in body hydration in each SGA category can be detected with BIVA

Antigene treatment direct against mutated Ki-ras with a PNA conjugated to a nuclear localisation derived peptide

4nonenoneCogoi S; Codognotto A; Rapozzi V; Xodo LECogoi, Susanna; Codognotto, A; Rapozzi, Valentina; Xodo, Luig

AUTOCRINE/PARACRINE STIMULATION OF PURINERGIC RECEPTORS IN OSTEOBLASTS: CONTRIBUTION OF VESICULAR ATP RELEASE

Extracellular nucleotides such as ATP and UTP are released in response to mechanical stimulation in different cell systems. It is becoming increasingly evident that ATP release plays a role in autocrine and paracrine stimulation of osteoblasts. Mechanical stimulation, as shear stress, membrane stretch or hypo-osmotic swelling, as well as oscillatory fluid flow, stimulates ATP release from different osteoblastic cell lines. Human osteoblast-like initial transfectant (HOBIT) cells release ATP in response to mechanical stimulation. In the present study, we show that HOBIT cells are activated by nanomolar levels of extracellular ATP, concentrations that can be detected under resting conditions and increase following hypotonic shock. Cell activation by hypotonic medium induced intracellular Ca2+ oscillations, and Egr-1 synthesis and DNA-binding activity. Quinacrine staining of living, resting cells revealed a granular fluorescence, typical of ATP-storing vesicles. Monensin prevented quinacrine staining and considerably inhibited hypotonic- induced ATP release. Finally, elevated levels of cytosolic Ca2+ activated massive ATP release and a dose-dependent loss of quinacrine granules. The contribution of a vesicular mechanism for ATP release is proposed to sustain paracrine osteoblast activation