Body composition in spinal cord injury

A study of body composition was conducted on 45 patients with spinal cord injury (SCI) and 12 able-bodied healthy subjects who served as controls. Body composition was assessed in terms of water (W), fat (F), protein (P), and mineral (M) content. SCI patients exhibited lower absolute amounts of W, F, and P, but no differences in the the amounts of these components when expressed relative (percentage) to gross body weight (BW). As estimated in this study, the amount of bone mass constituted a higher percentage of the gross BW. This suggests that, although SCI patients lose calcium in the early stages of the disease, the loss of weight that follows SCI is principally due to the loss of W, F, and P.     

Incidence of venous thromboembolism in patients with cancer – A cohort study using linked United Kingdom databases

BackgroundAccurate population-based data are needed on the incidence of venous thromboembolism (VTE) in patients with different cancers in order to inform guidelines on which hospitalised and ambulatory cancer patients should receive VTE prophylaxis.MethodsWe conducted a cohort study using data from the Clinical Practice Research Datalink, linked to Hospital Episode Statistics, Cancer Registry data and Office for National Statistics cause of death data. We determined the incidence rates (cases per 1000 person–years) of VTE separately for 24 cancer sites. To determine relative risk, incidence rates were compared to frequency-matched controls (by age) with no record of cancer.FindingsWe identified 83,203 cancer patients and 577,207 controls. New cases of VTE were diagnosed in 3352 cancer patients, and 6353 controls. The absolute rate of VTE in all cancers was 13.9 per 1000 person–years (95% confidence interval [CI] 13.4–14.4), corresponding to an age, sex and calendar year adjusted hazard-ratio of 4.7 (CI 4.5–4.9) between cancer patients and the general population. Rates varied greatly by cancer site (range; 98 (CI 80–119) in pancreatic cancer to 3.1 (CI 1.5–6.5) in thyroid cancer), age (range; 16.9 for patients over 80 years to 4.9 for those under 30 years) and time from diagnosis (range; 75 in the first three months to 8.4, >1 year after diagnosis).InterpretationVTE is strongly linked to cancer, but the annual rate varies greatly by cancer site, proximity to diagnosis and age. Prophylaxis guidelines should take account of cancer site and such intervention should also be targeted towards the three months following diagnosis.     

Risk of mortality from suicide in patients with Huntington’s disease is increased compared to the general population in England

Journal of Neurology - To examine the relative risk of suicide mortality in patients with Huntington’s disease (HD). A case–control study design was used. We used linked electronic...     

High 2,3-DPG blood cardioplegia and myocardial preservation during cardiopulmonary bypass

Blood may provide superior cardioplegia compared with crystalloid cardioplegic solution. However, the results are controversial. This may be due to a leftward shift of the hemoglobin (Hb)-O2 dissociation curve induced by hypothermia, increasing the oxygen affinity for Hb. This effect may negate the potential benefit of blood cardioplegia. The oxygen affinity for Hb can be decreased by increasing the red cell 2,3-diphosphoglycerate (2,3-DPG), and hence, more oxygen can be delivered to the myocardium. The present investigation was undertaken to study the effects of 2,3-DPG-enriched blood cardioplegia on the functional recovery of the myocardium and changes in the coronary sinus red blood cell (RBC) adenosine-triphosphate (ATP), lactate, and RBC DPG after one and a half hours of reperfusion following one hour of ischemic cardiac arrest in dogs. The dogs were divided into three groups: crystalloid (CR); stored blood (SB), and high 2,3-DPG blood (HDPG) cardioplegic groups. Incubation of canine RBC in phosphoenal pyruvate (PEP) led to a 36% increase in DPG and a rightward shift in the Hb-O2 dissociation curve. There was a 4 mm Hg shift in the P50. When compared with the CR group, there was a significant decrease in the cardiac index (CI) and left ventricular work index (LVWI) and a significant increase in the total systemic vascular resistance (TSVR) in the SB group. The CI and LVWI of the HDPG group were similar to those of the CR group, but the TSVR was significantly greater in the former group. The LVWI was significantly greater and the TSVR smaller in the HDPG group as compared with those in the SB group.(ABSTRACT TRUNCATED AT 250 WORDS)