Hubungan Lama Penggunaan Kontrasepsi Hormonal terhadap Skor Inner Scan Body Composition Monitor pada Wanita Usia Subur

Osteoporosis merupakan masalah kesehatan dunia dimana saat ini diderita oleh kelompok usia yang lebih muda. Kepadatan mineral tulang merupakan salah satu jenis parameter dalam mengukur status osteoporosis. Semakin rendah kepadatan mineral tulang maka semakin besar risiko osteoporosis. Salah satu faktor risiko rendahnya kepadatan mineral tulang adalah jenis dan lama penggunaan kontrasepsi hormonal. Penelitian ini bertujuan untuk mengetahui hubungan penggunaan kontrasepsi hormonal dengan skor Inner Scan Body Composition Monitor dalam kepadatan tulang wanita usia subur. Metode penelitian yang digunakan adalah kuantitatif dengan desain cross sectional study, sampel penelitian 46 akseptor dengan teknik sampling yaitu Purposive sampling. Analisis data menggunakan Mann Whitney. Hasil penelitian didapatkanhasil untuk Skor Inner Scan Body Composition Monitor pada akseptor baru dengan nilai mean±SD yaitu 2.1429 ± 0.45779 dan nilai min-max adalah 1.40 – 3.00. Sementara pada akseptor lama dengan nilai mean±SD yaitu 2.3840 ± 0.38479 dan nilai min-max adalah 1.50 - 3.20. Pada analisis Bivariat didapatkannilai p= 0.086> 0,05, hal ini menunjukkan tidak Ada hubungan antara lama penggunaan kontrasepsi hormonal dengan skor inner scan bodyatau kepadatan tulang pada akseptor kontrasepsi hormonal. Kesimpulan, lama penggunaan kontrasepsi hormonal tidak mempengaruhi skor Inner Scan Body Composition Monitor pada kepadatan tulang akseptor di Wilayah Kota Makassar

Autonomic rhythm regulation of elite wrestlers with different dominance of brain hemisphere

The results of a study of the autonomous regulation of the heart rate in elite wrestlers with different dominance of the cerebral hemispheres were present in the manuscript 23 elite wrestlers. Were examined members of the National Team of Ukraine in Greco-Roman wrestling, aged 22-34 years-old. A body composition monitor "Omron BF511" and a computer electrocardiograph "Fazagraf" were used. It was revealed that elite wrestlers with a dominance of the right hemisphere have more intense regulation of the heart rhythm compared to wrestlers with a dominance of the left hemisphere of the brain. With an increase in the tension of the system of autonomous regulation of the heart rhythm in wrestlers with the dominance of the right hemisphere of the brain, the activation of the central and sympathetic division of regulation occurs. For the purpose of a more effective preparation process and in the development of individual training programs for elite wrestlers, it is necessary to determine the dominance of the cerebral hemispheres.

The equivalence of hydration status measured by the Fresenius BCM and the Cella Bioimpedance Spectroscopy devices on hemodialysis patients

BackgroundFluid management is a serious challenge for patients undergoing hemodialysis therapy (HD). Bioimpedance spectroscopy (BIS) is a promising technique to help with clinical hydration (HYD) assessment. The Fresenius Medical Care (FMC) Body Composition Monitor (BCM) is the standard but is large and expensive. Cella Medical has introduced a small wireless BIS device. This study compared the HYD status predicted by the two devices.MethodsFollowing the FMC BCM device manual guidelines, measurements of BIS were made wrist-ankle using typical ECG electrodes on the non-fistula side of HD patients pre dialysis while in their normal supine position. As usual, patients were measured before their normal time of therapy with the BCM. The Cella measurements were then performed within two minutes.ResultsForty-two HD patients (M=64%, age=64±30 yrs.), were measured. One patient data was removed. The mean BCM HYD status was 1.86 l, SD 1.46 l, and SEM 0.22 l. Cella was 1.806 l, SD 1.36 l, and the SEM 0.21 l. The 95% difference confidence interval (CI) was -0.66 to 0.55 l. The Pearson’s correlation (r) was r^2 = 0.85 (p<0.00001). There was no proportional bias: the offset was -0.056 l, and K=1.010. The limits of agreement (LOA) analysis showed a mean difference of 0.56 l, and limits d ±2SD = (−1.192 l, 1.081 l), indicating 95% of the difference will lie within these limits. To evaluate equivalence, we performed two one-sided t-tests (TOST). When the bounds were reduced to the limit =0.47 l and -0.59 l, we obtained a 0.046 p-value (alpha =0.05), at 80% statistical power. For 26% of the subjects, the difference was <0.1 l, for 43% <0.25 l, for 71% <0.5 l, for 83% <0.75 l, for 90% <1.0 l, and for 9.5% (4 patients) more than 1 l. Only two cases (4.8%) were just over the ±2SD limit.ConclusionThis study suggests the BCM and Cella devices can be used interchangeably.

Body composition monitoring in children and adolescents: reproducibility and reference values

There is an increasing need for suitable tools to evaluate body composition in paediatrics. The Body Composition Monitor (BCM) shows promise as a method, but reference values in children are lacking. Twenty children were included and measured twice by 4 different raters to asses inter- and intra-rater reproducibility of the BCM. Reliability was assessed using the Bland-Altman method and by calculating intraclass correlation coefficients (ICCs). The intra-rater ICCs were high (≥ 0.97) for all parameters measured by BCM as were the inter-rater ICCs for all parameters (≥ 0.98) except for overhydration (0.76). Consequently, a study was set up in which BCM measurements were performed in 2058 healthy children aged 3–18.5 years. The age- and gender-specific percentile values and reference curves for body composition (BMI, waist circumference, fat mass and lean tissue mass) and fluid status (extracellular and intracellular water and total body water) relative to age were produced using the GAMLSS method for growth curves.Conclusion: A high reproducibility of BCM measurements was found for fat mass, lean tissue mass, extracellular water and total body water. Reference values for these BCM parameters were calculated in over 2000 children and adolescents aged 3 to 18 years. What is Known• The 4-compartment model is regarded as the ‘gold standard’ of body composition methods, but is inappropriate for regular follow-up or screening of large groups, because of associated limitations. • Body Composition Monitor® is an inexpensive field method that has the potential to be an adequate monitoring tool.What is New• Good reproducibility of BCM measurements in children provides evidence to use the device in longitudinal follow-up, multicentre and comparative studies.• Paediatric reference values relative to age and sex for the various compartments of the body are provided.

Comparison of Body Composition Monitor and InBody 720 Bioimpedance Devices for Body Composition Estimation in Hemodialysis Patients and Healthy Controls

Bioelectric impedance devices have become a standard of care not only for peritoneal dialysis but also for hemodialysis patients. We compared the most important body composition variables (extracellular water, intracellular water, total body water and fat mass) measured with the multifrequency bioelectric impedance device InBody 720 (MF-BIA) and bioimpedance spectroscopy body composition monitor Fresenius (BIS BCM) in hemodialysis patients (n = 51, 175.1 + 7.8 cm, 82.2 + 15.2 kg) and healthy controls (n = 51, 175.1 + 7.6 cm, 82.3 + 15.3 kg). The MF-BIA InBody 720 device compared to the BIS BCM device showed significantly larger total body water and intracellular water estimates and significantly smaller extracellular water and body fat estimates in hemodialysis patients (p < 0.001). These differences (p < 0.001) were similar in the cohort of healthy controls; moreover, we observed high correlations in all variables between the hemodialysis patients and the healthy controls (0.80–0.95, p < 0.001). The mean relative differences in the order of 8% were lower for extracellular water and total body fat, but the limits of agreement were still wide enough to be clinically significant. We conclude that the results of the measurements with InBody 720 and BCM Fresenius cannot be used interchangeably. Physicians and nutritionists involved in the care of hemodialysis patients should be aware of this discrepancy between the two devices and should try to use the same device to track the body in their hemodialysis population in a longitudinal direction.

P1091DYNAMICS OF VASCULAR REFILLING IN EXTENDED NOCTURNAL HAEMODIALYSIS

Background and Aims Refilling volume had not been a measurable parameter in clinical practice so far, because the knowledge of absolute blood volume (BV) is necessary. Recently, we developed a simple method to determine absolute BV, thus enabling quantification of the refilling volume. The overnight dialysis is particularly suitable for studying the refilling process due to negligible external influences and the extended treatment time. Method At the beginning of the dialysis (t=0), before starting the ultrafiltration (UF), a defined online bolus of 240 ml dialysate was infused by pressing the emergency button on the haemodiafiltration (HDF) machine (5008, FMC). The subsequent increase in relative BV (RBVpost-RBVpre) was measured with the integrated BV monitor, and absolute BV at t=0 was calculated: absolute BV in ml = bolus volume 240 ml x 100% / increase in relative BV in%. Absolute BV at any other time t was calculated as: Vt = V0 x RBVt (in %) / 100 At constant UF rate refilling volume (Vref) is given for every hour (h) as: Vref h = UFV h – drop in absolute BVh (beginning – end) The refilling fraction is expressed as refilling/UF ratio: Ref% = Vref/UFV x 100, in % Before treatment, volume overload was evaluated by bioimpedance spectroscopy (BIS) using the body composition monitor (FMC). Results Refilling volume and refilling fraction were studied in 10 stable chronic haemodialysis (HD) patients during an extended (7 hour) nocturnal HD session. Specific BV at treatment start was 74.9 ± 11.8 mL/kg and dropped to 68.6 mL/kg at dialysis end. The constant UF rate was set to 406 ± 120 mL/h (specific UF rate 4.81 ± 1.83 mL/kg/h). In the first hour refilling volume amounted only to 23% of UF volume. Refilling fraction reached its maximum in the 2nd, 3 rd and 4th hour at about mean 90% (91.5%, 88.7%, and 91.1% respectively) of UF volume. From the 5th hour on, refilling volume and refilling fraction decreased (5th hour 81.3%, 6th hour 72.5%, and 7th hour 70.0% of UF volume). In the 5th hour, cumulative UF volume exceeded volume overload (1.1 ± 1.0 L) measured by BIS in 9 of 10 patients. Refilling fraction cumulatively increased up to the 4th hour. Thereafter, cumulative ratio remained constant at 70 – 75% due to the decrease in refilling volume. This did not change during the further course of dialysis. Cumulative refilling volume showed a strong correlation (r2 = 0.88; p&lt;0.001) with UF volume. Conclusion After the first hour, when sufficient refilling takes place, refilling volume is in a stable ratio of approximately 90 % of UF volume. Refilling is low in the first hour, and, therefore, refilling volume amounted cumulatively only about 70 to 75% of UF volume during usual dialysis duration. Thereby, absolute BV will be reduced by approximately 250 to 300 ml per liter UF. This must be taken into account in volume management in order to avoid intradialytic complications. As expected, refilling decreases when volume overload in the interstitial space is removed. Due to the reduced refilling, there will be an additional gap in BV.

P1466SYSTEMATIC LITERATURE REVIEW OF CLINICAL EVIDENCE FOR THE BODY COMPOSITION MONITOR IN DIALYSIS AND CKD

Background and Aims The Body Composition Monitor (BCM) is a bioimpedance spectroscopy device to monitor the hydration status of dialysis and CKD patients. NICE (UK) reported only limited evidence on the clinical effectiveness in its Diagnostic Guidance 29. The aim of this work was to provide a structured review of the available evidence up to September 2018 grouped by the most important clinical outcomes (fluid overload, blood pressure, mortality and cardiovascular events). Method MEDLINE, Embase and Cochrane databases were interrogated from 2006 to September 2018. Search and review of identified studies was conducted in compliance with the guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results Of 4497 articles identified, 843 were included for full-text review; 424 were full publications and were selected for further analysis. Eight randomized controlled trial (RCT) studies and 150 observational studies met the predefined inclusion criteria; of these, observational studies that recruited at least 100 patients and additionally reported important clinical outcomes such as mortality, cardiovascular (CV) events or hospitalization were selected. Two further RCTs were identified by supplementary searches, giving a total of 10 RCTs (total 2.156 patients) and 41 observational studies (total 168.453 patients) included in this review. The data was grouped by reported outcomes and for each outcome it was analyzed if an effect of BCM-monitored fluid management, or an association between BCM assessment and the respective outcome could be shown. A meta-analysis of the results was not conducted. Reduction of fluid overload RCTs have shown that BCM-monitored fluid management and subsequent alteration of dialysis parameters can lead to effective reduction of fluid overload. Lowering of blood pressure RCTs have indicated that BCM-monitored fluid management can effectively lower blood pressure. Impact on mortality / association with mortality Multiple observational studies have shown a strong association between BCM measurements and mortality. One RCT demonstrated that mortality outcomes can be significantly improved in HD patients with BCM-guided fluid management, while two RCTs reported no significant difference in mortality outcomes. Impact on Cardio Vascular (CV) related events Multiple observational studies have indicated that BCM measurements can predict CV events. One RCT indicated that CV events can be reduced by BCM-monitored fluid management, and two further RCTs indicated that using BCM guidance was at least as good as conventional fluid management. Conclusion There is a strong body of evidence for various important outcomes covering a large patient basis - additional evidence is needed in well designed randomized controlled trials e.g. to demonstrate the effect of reducing BCM determined dehydration.