We estimate that >16 million US adults have diagnosed DED. Prevalence is higher among women than men, increases with age, and is notable among those aged 18-34 years.
At doses that resulted in significant improvement in ADHD symptoms, impairment on cognitive tasks was not observed. Daytime sleepiness did not differ with GXR compared with placebo. Results suggest that the beneficial effects of GXR on ADHD symptoms are independent of sedation.
Findings illustrate the substantial functional impairment associated with childhood ADHD while highlighting the challenges of developing informant-reported outcome measures limited to observable content. Because ADHD has an impact on children's functioning in a wide range of contexts, a parent-report measure that includes only observable content may fail to capture important aspects of functional impairment. Approaches for addressing this observability challenge are discussed.
The purpose of this study was to conduct a retrospective analysis of serum phosphate level variability in patients new to hemodialysis (HD) and to identify patient characteristics associated with this variability. The medical records of 47,742 incident HD patients attending US outpatient dialysis centers between January 1, 2006 and March 31, 2009 were analyzed. Monthly mean serum phosphate levels determined over a 6-month evaluation period (months 4–9 after HD initiation) were assigned to one of three strata: low (<1.13 mmol/L [<3.5 mg/dL]); target (1.13–1.78 mmol/L [3.5–5.5 mg/dL]); or high (>1.78 mmol/L [>5.5 mg/dL]). Patients were classified into one of six serum phosphate variability groups based on variability among monthly mean phosphate levels over the 6-month evaluation period: consistently target; consistently high; high-to-target; high-to-low; target-to-low; or consistently low. Only 15% of patients (consistently target group) maintained monthly mean serum phosphate levels within the target range throughout the 6-month evaluation period. Age, Charlson comorbidity index, serum phosphate, and intact parathyroid hormone levels prior to HD initiation were strongly associated (P<0.001) with serum phosphate levels after HD initiation. Overall patient-reported phosphate binder usage increased from 35% at baseline to 52% at end of study. The low proportion of patients achieving target phosphate levels and low rates of phosphate binder usage observed during the study suggest that alternative strategies could be developed to control serum phosphate levels. Possible strategies that might be incorporated to help improve the management of hyperphosphatemia in incident HD patients include dietary modification, dialysis optimization, and earlier and sustained use of phosphate binders.
not been rated yet. We aimed to evaluate the agreement between indirect calorimetry (IC) and the predictive equations of Harris&Benedict (HB), Schofield and WHO/FAO 1985. Fifty-seven elderly patients (38 males (67%); 6976 years) on HD were included. The REE (kcal/day) estimated by the equations were higher than that measured by IC: IC (1246 7288); HB (1443 7279); Schofield (1357 7232); WHO 1985 (1384 7226) (Po0.05). The HB equation had the lowest intraclass correlation coefficient (ICC), the highest mean difference from the REE measured by IC and a high frequency of overestimation (Table). IntraclassCC (r; 95% CI) Bland-Altman * REE overestimation (%[n]) HB x REE 0.53(0.31;0.69) 188(-331; 709 59.6 [34] Schofield x REE 0.72(0.57;0.83) 112(-248; 472) 56.1 [32] WHO 1985 x REE 0.74(0.60;0.84) 139(-222; 499) 59.6 [34] n Mean difference and interquartile range; CI: confidence interval In conclusion, all predicted equations overestimated the REE in elderly HD patients. Among them, the HB equation had the worse agreement with IC.http://dx.The aim was to explore the relationships between malnutritioninflammation-athersclerosis (MIA) syndrome and low Triiodothyronine (T3) syndrome in older peritoneal dialysis (PD) patients. A cross-sectional survey was conducted in 109 PD patients visiting our clinic between March to April, 2009. Subjective global nutritional assessment (SGA) and lean body mass (LBM), arterial pulse pressure (PP), and serum thyroid profiles were measured. All patients were divided into two groups by age (Z 65 or o 65years ). There were higher prevalence of malnutrition (assessed by SGA, 28.6% vs 8.3%, P o0.05), greater PP (60.2 7 15.0 vs 52.0 7 20.2mmHg, Po 0.05), and higher levels of serum C-reactive protein (CRP, 9.02 7 10.4 vs 3.43 7 5.09 mg/L, Po 0.05) in 49 older patients compared to the younger. Higher prevalence of low T3 syndrome (42.9% vs 21.7%, Po 0.05) and lower levels of serum free T3 (fT3, 2.41 7 0.35 vs 2.57 7 0.31 pg/ml, Po 0.05) were found in older people. There were significant correlations between serum fT3 and LBM (r¼0.297, P o0.05), CRP (r ¼ À0.302, P o0.05), and PP (r¼ À0.284, P o0.05) in older people but not in the younger. In conclusion, Older PD patients are more susceptible to MIA syndrome and low T3 syndrome than the younger, a vicious circle may exist between these two syndromes in this population.http://dx.Hyperphosphataemia is associated with increased all-cause mortality in patients with chronic kidney disease (CKD), but serum phosphate (P) levels can be managed by dialysis, diet and the use of P binders. Serum P data were obtained retrospectively from a US dialysis provider for the 9 months following initiation of haemodialysis (HD) in CKD patients, who were then grouped according to the variations in their serum P. Group baseline characteristics and changes in P binder use over time were described.Variations in average monthly serum P values from months 4 to 9 were classified as either consistently in the target range (CT, 3.5-5.5 mg/dL), consistently low (CL, o 3.5 mg/dL), ...
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