PubMed · 13957734
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F R JEVONS. HARVEY'S quantitative method.. https://pubmed.ncbi.nlm.nih.gov/13957734/
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The metabolic syndrome (MS) is a cluster of metabolic abnormalities leading to increased risk for cardiovascular diseases and diabetes type 2. Its prevalence is increasing with aging. There exists actually an epidemic of MS. Visceral obesity and the resulting insulin resistance (IR) are the major determinant in the development of the MS. Abdominal obesity results in a low grade inflammation via the adipose tissue and macrophages secreted adipokines. This inflammation, via the generated pro-inflammatory molecules, interferes with the normal insulin signalling and thus contributes to the etiopathogenesis of the MS. Large clinical studies showed that CRP is increased in obese subjects and concomitantly to the number of existing component of the MS. Treatment of the MS is aimed to improve the IR by lifestyle changes including exercise and diet alone or in combination with medication targeting the individual components but having also anti-inflammatory actions. More research is needed to bring new therapies to be able to decrease the incidence and prevalence of the MS among the population and thus increasing their quality of life.
BACKGROUND: Glucose infusion test (GIT) is a new method to measure vascular access recirculation (R) based on basal glucose increase in the arterial blood line after a 20% glucose bolus (5 ml) into the venous chamber. METHODS: We compared GIT with the ultrasound dilution method (HD01, Transonic Systems Inc., USA) in a circuit reproducing in vitro the phenomenon of R. We repeated the comparison in 162 chronic haemodialysis patients (133 fistulae, 17 central venous catheters, 12 prosthetic grafts). RESULTS: In vitro, we determined the timing for C2 sampling: QB 200 ml/min, C2 16-20 s; QB 300 ml/min, C2 13-17 s; QB 400 ml/min, C2 9-12 s. GIT showed no false positives nor false negatives (100% specificity and sensitivity) while HD01 did not recognize three cases with R=5% (91% sensitivity) and it yielded no false positive (100% specificity). The Bland-Altman analysis showed a bias of 0.2+/-1.3% and 1.3+/-2.9% for GIT and HD01, respectively. In vivo, only 16 out of 162 patients were found positive with both methods (GIT 13.5+/-13%; HD01 16.3+/-15%; P=NS) while three patients with minimal R (GIT 3.2%) were not recognized by HD01 although a low R peak was clearly evident and repeatable on the laptop plot. The Bland-Altman analysis showed an overall bias of 0.2+/-1.7% to the limits of agreement=-3.1 and 3.6% (n=162) and no correlation between the difference and the mean of positive tests. The pooled coefficient of variation of positive cases was 13.3 and 18.1% for GIT and HD01, respectively. DISCUSSION: Our in vitro study showed a good performance of GIT and its better sensitivity compared to HD01. These results were confirmed in vivo with only 3/162 discordant results due to a low R under the HD01 limit of detection (R=5%). In conclusion, the GIT proved to be a very accurate screening test for R, with a very low threshold of detection. In addition, it is simple, user-friendly and inexpensive.
A particle method for the computer simulation of blood flow was proposed to analyze the motion of a deformable red blood cell (RBC) in flowing blood plasma. The RBC and plasma were discretized by particles that have the characteristics of an elastic membrane and a viscous fluid, respectively. The membrane particles were connected to their neighboring membrane particles by springs, and the motion of the particles was determined on the basis of the minimum energy principle. The incompressible flow of plasma that was expressed by the motion of the fluid particles was determined by the moving-particle semi-implicit (MPS) method. The RBC motion and plasma flow were weakly coupled. The two-dimensional simulation of blood flow between parallel plates demonstrated the capability of the proposed method to express the blood flow phenomena observed in experiments, such as the downstream motion of the RBC and the deformation of the RBC into a parachute shape.