A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Principles of Hand Fracture Management

The hand is essential in humans for physical manipulation of their surrounding environment. Allowing the ability to grasp, and differentiated from other animals by an opposing thumb, the main functions include both fine and gross motor skills as well as being a key tool for sensing and understanding the immediate surroundings of their owner

Aggregative feeding behavior in sea urchins leads to destructive grazing in a Nova Scotian kelp bed

Grazing aggregations of the sea urchin Strongylocentrotus droebachiensis drive the transition between alternative ecosystem states in Nova Scotia, from productive kelp beds to less productive barrens. This transition can be initiated by the formation of gaps within a kelp bed, containing dense aggregations of sea urchins. We examined the importance of local density of sea urchins and pre-existing gaps in a kelp canopy in mediating the formation of destructive grazing aggregations of sea urchins in a kelp bed. We transplanted 14 000 adult sea urchins from a barrens on the Atlantic coast of Nova Scotia into ̃4.5 m 2 plots within a nearby kelp bed, at densities above and below a predicted threshold value for destructive grazing, and simulated disturbance to the kelp bed by removing the kelp canopy in half of the plots. Sea-urchin abundance and gap formation and expansion (as loss of kelp canopy cover) were monitored in and around plots weekly for 9 wk. Grazer-mediated gap formation began 3 wk after sea urchins were introduced, and increased for the remainder of the experiment. Our results indicate a direct linear relationship between sea-urchin abundance and increase in gap area within undisturbed treatments. Gaps expanded in the kelp bed at seaurchin densities below the putative threshold for destructive grazing, indicating that the kelp bed was less resilient to grazing than predicted. Our findings provide insights into mechanisms controlling the stability of the kelp-bed ecosystem state and mediating shifts from kelp beds to barrens in Nova Scotia

Micro-structural bone changes in early rheumatoid arthritis persist over 1-year despite use of disease modifying anti-rheumatic drug therapy

Abstract Background We used High Resolution – peripheral Quantitative CT (HR-pQCT) imaging to examine peri-articular bone quality in early rheumatoid arthritis (RA) and explore whether bone quality improved over 12-months in individuals receiving care consistent with practice guidelines. Methods A 1-year longitudinal cohort study (Baseline and 12-months) evaluating individuals with early RA compared to age/sex-matched peers. Personal demographic and health and lifestyle information were collected for all. Whereas, active joint count (AJC28), functional limitation, and RA medications were also collected for RA participants. HR-pQCT imaging analyses quantified bone density and microstructure in the Metacarpal Head (MH) and Ultra-Ultra-Distal (UUD) radius at baseline and 12-months. Analyses included a General Linear Modelling repeated measures analyses examined main effects for disease, time, and interaction on bone quality. Results Participants (n = 60, 30 RA/30 NRA); 80% female, mean age 53 (varying from 21 to 74 years). At baseline, RA participants were on average 7.7 months since diagnosis, presenting with few active joints (AJC28: 30% none, remaining 70% Median 4 active joints) and minimal self-reported functional limitation (mHAQ-DI0–3: 0.56). At baseline, 29 of 30 RA participants had received one or more non-biologic disease-modifying anti-rheumatic drugs (DMARD);13 in combination with glucocorticoid and 1 in combination with a biologic medication. One participant only received glucocorticoid medication. Four RA participants withdrew leaving 26 pairs (n = 52) at 12-months; 23 pairs (n = 46) with UUD and 22 pairs (n = 44) with MH baseline and 12-month images to compare. Notable RA/NRA differences (p < 0.05) in bone quality at all three sites included lower trabecular bone density and volume, more rod-like trabeculae, and larger and more variable spaces between trabeculae; fewer trabeculae at the UUD and MH2 sites; and lower cortical bone density and volume in the MH sites. Rate of change over 12-months did not differ between RA/NRA participants which meant there was also no improvement over the year in RA bone quality. Conclusions Early changes in peri-articular bone density and microstructure seen in RA are consistent with changes more commonly seen in aging bone and are slow or resistant to recover despite well controlled inflammatory joint symptoms with early DMARD therapy