Calculated estimates of GFR are an improvement over ClCr estimation. On balance, the MDRD formula does not improve the estimate of GFR compared with the Cockcroft and Gault formula in older Caucasian patients with chronic renal insufficiency.

Summary Background There are few studies that directly compare the variation in incidence of venous thromboembolism (VTE) according to ethnicity. Objective The aim of this study was to compare the rates of VTE, deep venous thrombosis (DVT) and pulmonary embolism (PE) among different ethnic groups. Method The cases diagnosed with VTE, DVT and PE for a period between March 2004 and June 2009 were identified through the hospital‐based database system. The 2006 New Zealand Census data were used to calculate the rate of diagnosis. Results The observed annual incidence of VTE during this period was 81.6 per 100 000 population. The relative risks of VTE when comparing European subjects with Maori, Pacific Island and Asian subjects after age standardization were 1.98 (95% confidence interval [CI], 1.63–2.41), 3.22 (95% CI, 2.60–3.99) and 4.02 (95% CI, 3.34–4.84), respectively. Relative risks of DVT after age standardization when comparing European subjects with Maori, Pacific Island and Asian subjects, were 2.14 (95% CI, 1.72–2.66), 3.20 (95% CI, 2.46–4.17) and 4.75 (95% CI, 3.80–5.94), respectively. Indirect age standardization was used for comparison of the diagnosis of PE. The ratio between the calculated expected number of cases and the actual number of cases was 1.32 (95% CI, 0.89–1.75) for Maori subjects, 2.96 (95% CI, 1.89–4.03) for Pacific Islanders and 3.89 (95% CI, 3.00–4.78) for Asians. Conclusion Europeans have a significantly higher incidence of VTE compared with Maori, Pacific Island and Asian populations.

Defects in induction signaling and response underlie the nucleocytoplasmic incompatibility between two evolutionarily distant frog species, while specific treatments partially restore this response in explants and whole embryos.

SUMMARYAim: To establish whether bone disease is present at diagnosis in inflammatory bowel disease and to identify contributory metabolic abnormalities. Methods: Newly diagnosed patients with inflammatory bowel disease (19 males, 15 females; mean age, 44 years; range, 17-79 years; 23 ulcerative colitis, 11 Crohn's disease) were compared against standard reference ranges and a control group with irritable bowel syndrome (eight males, 10 females; mean age, 40 years; range, 19-64 years). Bone mineral density (g ⁄ cm 2 , dual-energy X-ray absorptiometry: lumbar spine and femoral neck) and biochemical bone markers were measured. Results: Femoral neck bone mineral density, T-and Z-scores (mean ± s.d., respectively) were lower in inflammatory bowel disease patients than in irritable bowel syndrome controls (0.78 ± 0.12 vs. 0.90 ± 0.16, P ¼ 0.0046; ) 0.88 ± 0.92 vs. 0.12 ± 1.17, P ¼ 0.0018; ) 0.30 ± 0.89 vs. 0.61 ± 1.10, P ¼ 0.0030). Lumbar spine bone mineral density and T-scores were also significantly lower in patients than controls (0.98 ± 0.15 vs. 1.08 ± 0.13, P ¼ 0.0342; ) 1.05 ± 1.39 vs. ) 0.14 ± 1.19, P ¼ 0.0304). Compared with controls, the urinary deoxypyridinoline : creatinine ratio was increased (7.66 vs. 5.70 nmol ⁄ mmol, P ¼ 0.0163) and serum 25-hydroxy vitamin D was decreased (18.7 vs. 28.5 lg ⁄ L, P ¼ 0.0016); plasma osteocalcin and serum parathyroid hormone did not differ (P > 0.05). Conclusions: The bone mineral density is reduced at diagnosis, prior to corticosteroid treatment, in both Crohn's disease and ulcerative colitis. Our data suggest that this is attributable to increased resorption rather than decreased bone formation.

Objective: To explore potential factors that could be associated with low bone mineral density (BMD) in female endurance runners. Methods: Fifty two female endurance runners (1500 m to marathon), aged 18-44 years, took part. Body fat percentage, lumbar spine BMD, and femoral neck BMD were measured using the Hologic QDR 4500w bone densitometer. Data on training, menstrual cycle status, osteoporosis, and health related factors were obtained by questionnaire. Dietary variables were assessed from a prospective seven day dietary record of macronutrients and micronutrients. Results: The mean (SD) lumbar spine and femoral neck BMD were 1.11 (0.11) and 0.89 (0.12) g/cm 2 respectively. A backward elimination regression analysis showed that age, body mass, body fat, distance run, magnesium, and zinc intake were the variables significantly associated with BMD. Lumbar spine BMD (g/cm 2 ) = −1.90 + (0.0486 × age (years)) + (0.342 × log mass (kg)) − (0.000861 × age 2 (years)) − (0.00128 × distance (km/week)), with an R 2 = 30.1% (SEE = 0.089 (95% confidence interval (CI) 0.05 to 0.23); p<0.001). Femoral neck BMD (g/cm 2 ) = −2.51 − (0.00989 × age (years)) + (0.720 × log mass (kg)) + (0.000951 × magnesium (mg/day)) −(0.0289 × zinc (mg/day)) − (0.00821 × body fat (%)) − (0.00226 × distance (km/week)), with an R 2 = 50.2% (SEE = 0.100 (95% CI 0.06 to 0.22); p<0.001). The negative association between skeletal BMD and distance run suggested that participants who ran longer distances had a lower BMD of the lumbar spine and femoral neck. Further, the results indicated a positive association between body mass and BMD, and a negative association between body fat and BMD. Conclusions: The results suggest a negative association between endurance running distance and lumbar spine and femoral neck BMD, with a positive association between body mass and femoral neck and lumbar spine BMD. However, longitudinal studies are required to assess directly the effect of endurance running and body mass on BMD, and to see if the addition of alternative exercise that would increase lean body mass would have a positive effect on BMD and therefore help to prevent osteoporosis.

Serum cystatin C is a simple and sensitive screening test for kidney dysfunction in older people.

A combination of running exercise and calcium intake would appear to stimulate the bone mass of women endurance runners at lower-body sites but at the expense of bone mass at upper-body sites.

The effect of two methods for standardizing dual-energy X-ray absorptiometry (DXA) measurements on patient classification by the T-score has been determined for a group of over 2000 patients. The methods proposed by the International DXA Standardization Committee and the European Community's COMAC-BME group were used in conjunction with young reference data from the major DXA manufacturers, the COMAC-BME group and the third US National Health and Nutrition Examination Survey (NHANES III). The two standardization techniques produced dissimilar classifications as measured by the kappa statistic (kappa = 0.34-0.90), especially for the femoral neck, with up to 24.3% of patients reclassified from osteopenic to normal and 18.6% reclassified from osteoporotic to osteopenic when the standardization method was changed. Considering the effects of both reference data and standardization techniques together, there was a wide variation of patient classification, with the number of patients classified as osteoporotic varying from 9.6% to 21.1% for the postero-anterior spine L2-4 region and from 2.3% to 27.6% for the femoral neck. The agreement between different classifications ranged widely, from very poor to excellent (kappa = 0.02-0.98). The creation of standardized reference data must be an important priority in order to harmonize patient management using standardized BMD measurements. The choice of standardization technique, however, must be addressed in light of the results presented here.