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Evaluating the association of water intake and hydration status with nephrolithiasis risk at the population level.
It is a cross-sectional study in which daily total plain water intake and total fluid intake were estimated together with blood osmolality, urine creatinine, urine osmolality, urine flow rate (UFR), free water clearance (FWC) and urine/blood osmolality ratio (Uosm:Bosm). The associations of fluid intake and hydration markers with nephrolithiasis were evaluated using multivariable logistic regression.
General US population.
A total of 8195 adults aged 20 years or older from the National Health and Nutritional Examination Survey 2009–2012 cycles.
The population medians (interquartile ranges, IQR) for daily total plain water intake and total fluid intake were 807 (336–1481) and 2761 (2107–3577) ml/d, respectively. The adjusted OR (95 % CI) of nephrolithiasis for each IQR increase in total plain water intake and total fluid intake were 0·92 (95 % CI 0·79, 1·06) and 0·84 (95 % CI 0·72, 0·97), respectively. The corresponding OR of nephrolithiasis for UFR, blood osmolality, Uosm:Bosm and urine creatinine were 0·87 (95 % CI 0·76, 0·99), 1·18 (95 % CI 1·06, 1·32), 1·38 (95 % CI 1·17, 1·63) and 1·27 (95 % CI 1·11, 1·45), respectively. A linear protective relationship of fluid intake, UFR and FWC with nephrolithiasis risk was observed. Similarly, positive dose–response associations of nephrolithiasis risk with markers of insufficient hydration were identified. Encouraging a daily water intake of >2500 ml/d and maintaining a urine output of 2 l/d was associated with a lower prevalence of nephrolithiasis.
This study verified the beneficial role of general water intake recommendations in nephrolithiasis prevention in the general US population.
The impact of the outbreak of severe acute respiratory syndrome (SARS) was enormous, but few studies have focused on the infectious and general health status of healthcare workers (HCWs) who treated patients with SARS.
We prospectively evaluated the general health status of HCWs during the SARS epidemic.The Medical Outcome Study Short-Form 36 Survey was given to all HCWs immediately after caring for patients with SARS and 4 weeks after self-quarantine and off-duty shifts. Tests for detection of SARS Coronavirus antibody were performed for HCWs at these 2 time points and for control subjects during the SARS epidemic.
Tertiary care referral center in Taipei, Taiwan.
Ninety SARS-care task force members (SARS HCWs) and 82 control subjects.
All serum specimens tested negative for SARS antibody. Survey scores for SARS HCWs immediately after care were significantly lower than those for the control group (P < .05 by the t test) in 6 categories. Vitality, social functioning, and mental health immediately after care and vitality and mental health after self-quarantine and off-duty shifts were among the worst subscales. The social functioning, role emotional, and role physical subscales significantly improved after self-quarantine and off-duty shifts (P < .05, by paired t test). The length of contact time (mean number of contact-hours per day) with patients with SARS was associated with some subscales (role emotional, role physical, and mental health) to a mild extent. The total number of contact-hours with symptomatic patients with SARS was a borderline predictor (adjusted R2 = 0.069; P = .038) of mental health score.
The impact of the SARS outbreak on SARS HCWs was significant in many dimensions of general health. The vitality and mental health status of SARS HCWs 1 month after self-quarantine and off-duty shifts remained inferior to those of the control group.
To determine risk factors for hemodialysis catheter-related bloodstream infections (HCRBSIs) and investigate whether use of maximal sterile barrier precautions would prevent HCRBSIs.
Tertiary-care medical center hemodialysis unit.
Open trial with historical comparison and case-control study of risk factors for HCRBSIs.
Prospective surveillance was used to compare HCRBSI rates for 1 year before and after implementation of maximal sterile barrier precautions. A case–control study compared 50 case-patients with HCRBSI with 51 randomly selected control-patients.
The HCRBSI rate was 1.6% per 100 dialysis runs (CI95, 1.1%–2.3%) in the first year and 0.77% (CI95, 0.5%–1.1%) in the second year (P = .0106). The most frequent cause of HCRBSI was MRSA in the first year (15 of 32) and MSSA in the second year (13 of 18). Ten MRSA blood isolates in the first year were identical by PFGE. Diabetes mellitus was a risk factor for HCRBSI. Age, gender, site of hemodialysis central venous catheter (CVC), other underlying diseases, coma score, APACHE II score, serum albumin level, and cholesterol level were not associated with HCRBSI and did not change between the 2 years. Hospital stay was prolonged for case-patients (32.78 ± 20.96 days) versus control-patients (22.75 ± 17.33 days), but mortality did not differ.
Use of maximal sterile barrier precautions during the insertion of CVCs reduced HCRBSIs in dialysis patients and seemed cost-effective. Diabetes mellitus was associated with HCRBSI. An outbreak of MRSA in the first year was likely caused by cross-infection via medical personnel.
The Figure 2 caption that was published in the above referenced
article (Volume 9, Number 2, 2000, pp. 344–352) is incorrect.
We are reproducing Figure 2 below with its correct caption.
As a consequence of this error, we are reprinting the following
section from Results and discussion.
The in vitro refolding of hen egg-white lysozyme
is studied in the presence of various osmolytes. Proline
is found to prevent aggregation during protein refolding.
However, other osmolytes used in this study fail to exhibit
a similar property. Experimental evidence suggests that
proline inhibits protein aggregation by binding to folding
intermediate(s) and trapping the folding intermediate(s)
into enzymatically inactive, “aggregation-insensitive”
state(s). However, elimination of proline from the refolded
protein mixture results in significant recovery of the
bacteriolytic activity. At higher concentrations (>1.5
M), proline is shown to form loose, higher-order molecular
aggregate(s). The supramolecular assembly of proline is
found to possess an amphipathic character. Formation of
higher-order aggregates is believed to be crucial for proline
to function as a protein folding aid. In addition to its
role in osmoregulation under water stress conditions, the
results of this study hint at the possibility of proline
behaving as a protein folding chaperone.
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