Correction to: Comparison of the clinical effectiveness and safety between the use of denosumab vs bisphosphonates in renal transplant patients.

The original version of this article, published on 03 January 2020 contained a mistake. An author's name was misspelled.

Comparison of the clinical effectiveness and safety between the use of denosumab vs bisphosphonates in renal transplant patients.

A retrospective chart review was conducted on 85 renal transplant patients aged 19-88 years, treated with denosumab or bisphosphonate therapy. Bone densitometry measures were compared between treatment groups at baseline; at years 1, 2, and 3; and at final follow-up (average of 3.4 years). Both bisphosphonate and denosumab treatments increased lumbar spine bone density; however, the effect of denosumab was greater compared with that of bisphosphonate treatment. Denosumab treatment increased femoral neck BMD, whereas bisphosphonate treatment had a mean decrease in femoral neck BMD at final follow-up. Thus, our study provides evidence for the efficacy of denosumab treatment in renal transplant patients. Caution around hypocalcemia is warranted. We recommend more prospective studies to analyze the effects of long-term antiresorptive therapy in patients with a renal transplant. INTRODUCTION: To compare the clinical effectiveness and safety between the use of denosumab and bisphosphonates on bone density and incidence of adverse events in renal transplant patients. METHODS: A retrospective chart review was conducted on 85 renal transplant patients aged 19-88 years, treated with denosumab or bisphosphonate therapy. Bone densitometry measures were compared between treatment groups at baseline; years 1, 2, and 3; and at final follow-up (average of 3.4 years). RESULTS: Absolute change in lumbar spine and femoral neck BMD over the treatment period was 0.029 ± 0.075 g/cm2 and - 0.003 ± 0.064 g/cm2, respectively, in the bisphosphonate group. Absolute change in lumbar spine and femoral neck BMD at final follow-up was 0.072 ± 0.094 g/cm2 and 0.025 ± 0.063 g/cm2, respectively, in the denosumab group. Denosumab resulted in significantly greater increases in lumbar spine BMD (0.045 g/cm2 greater in the denosumab group). Similarly, the absolute change in BMD at the femoral neck was 0.022 g/cm2 greater in the denosumab group as compared with the bisphosphonate group. The denosumab group had one event of severe hypocalcemia following first injection and one report of hospitalized pneumonia. No serious adverse events were reported in the bisphosphonate group. CONCLUSIONS: Both treatments increased lumbar spine BMD; however, the effect of denosumab was greater compared with that of bisphosphonate treatment. Our study provides evidence for the efficacy of denosumab treatment in renal transplant patients. Caution around hypocalcemia is warranted. We recommend more prospective studies to analyze the effects of long-term antiresorptive therapy in patients with a renal transplant.

Fluid type and the use of renal replacement therapy in sepsis: a systematic review and network meta-analysis.

Fluid resuscitation, along with the early administration of antibiotics, is the cornerstone of treatment for patients with sepsis. However, whether differences in resuscitation fluids impact on the requirements for renal replacement therapy (RRT) remains unclear. To examine this issue, we performed a network meta-analysis (NMA), including direct and indirect comparisons, that addressed the effect of different resuscitation fluids on the use of RRT in patients with sepsis. The data sources MEDLINE, EMBASE, ACPJC, CINAHL and Cochrane Central Register were searched up to March 2014. Eligible studies included randomized trials reported in any language that enrolled adult patients with sepsis or septic shock and addressed the use of RRT associated with alternative resuscitation fluids. The risk of bias for individual studies and the overall certainty of the evidence were assessed. Ten studies (6664 patients) that included a total of nine direct comparisons were assessed. NMA at the four-node level showed that an increased risk of receiving RRT was associated with fluid resuscitation with starch versus crystalloid [odds ratio (OR) 1.39, 95% credibility interval (CrI) 1.17-1.66, high certainty]. The data suggested no difference between fluid resuscitation with albumin and crystalloid (OR 1.04, 95% CrI 0.78-1.38, moderate certainty) or starch (OR 0.74, 95% CrI 0.53-1.04, low certainty). NMA at the six-node level showed a decreased risk of receiving RRT with balanced crystalloid compared to heavy starch (OR 0.50, 95% CrI 0.34-0.74, moderate certainty) or light starch (OR 0.70, 95% CrI 0.49-0.99, high certainty). There was no significant difference between balanced crystalloid and saline (OR 0.85, 95% CrI 0.56-1.30, low certainty) or albumin (OR 0.82, 95% CrI 0.49-1.37, low certainty). Of note, these trials vary in terms of case mix, fluids evaluated, duration of fluid exposure and risk of bias. Imprecise estimates contributed to low confidence in most estimates of effect. Among the patients with sepsis, fluid resuscitation with crystalloids compared to starch resulted in reduced use of RRT; the same may be true for albumin versus starch.

Long-term effects of flipper bands on penguins.

Changes in seabird populations, and particularly of penguins, offer a unique opportunity for investigating the impact of fisheries and climatic variations on marine resources. Such investigations often require large-scale banding to identify individual birds, but the significance of the data relies on the assumption that no bias is introduced in this type of long-term monitoring. After 5 years of using an automated system of identification of king penguins implanted with electronic tags (100 adult king penguins were implanted with a transponder tag, 50 of which were also flipper banded), we can report that banding results in later arrival at the colony for courtship in some years, lower breeding probability and lower chick production. We also found that the survival rate of unbanded, electronically tagged king penguin chicks after 2-3 years is approximately twice as large as that reported in the literature for banded chicks.

Impairment of growth and immune function of avocet chicks from sites with elevated selenium, arsenic, and boron.

Avocets (Recurvirostra americana) hatched from eggs collected from the south Central Valley of California (USA) were studied to determine the impact of elevated concentrations of selenium, arsenic, and boron on the immune system and growth to maturity. Corcoran ponds were the reference site with low selenium (1.2 ppb) and arsenic (29 ppb) (boron not measured). Westfarmers Pond had elevated concentrations of selenium (319 ppb), arsenic (127 ppb), and boron (109 ppm). Pryse ponds also had elevated selenium, arsenic, and boron concentrations (13.9 ppb, 1,100 ppb, and 29.4 ppm, respectively). Size at hatch was significantly reduced (P < or = 0.05) in birds from Westfarmers and Pryse ponds. The growth rate was faster, but mean adult size was reduced in birds from Pryse ponds. Avocet chicks from Pryse and Westfarmers ponds exposed solely through in ovo transfer of these elements had significantly increased heterophil:lymphocyte ratios. The phagocytic activity of macrophages also was significantly reduced in these birds, and Pryse Pond birds had an increased proliferative ability of lymphocytes in the presence of concanavalin A, a T-cell mitogen. Avocet chicks (< or = 5 wk old) were captured from the various ponds and the same morphometric and immune function measurements made. The birds that were most severely impacted by exposure to these compounds were those that were collected from Pryse ponds.

A Quantitative Method for Delineating Regions: An Example for theWestern Corn Belt Plains Ecoregion of the USA

/ A method was developed to systematically delineate boundaries forecological classification of regions. The process entailed the use ofsmall-scale digital data to quantify spatial concordance among environmentalattribute data sets. The data sets were grouped into spatially related themesusing cluster analysis and multidimensional scaling. Selected data sets werethen used either individually or collectively to divide the study area intosubregions that exhibited different environmental attributes. The method wasapplied to a previously defined ecological unit, the western Corn Belt of thecentral United States. The results showed that the portion of the study areawith intensive corn and soybean production was identifiable using each of thethree input data sets selected for partitioning (soil associations; AVHRRremote-sensing imagery; and a combined data set of landform, forest, andsoils data). The classification of other portions of the study area washighly dependent on the type and scale of the input data. The systematicmethodology used here offers advantages over other methods for identifyingecological regions in that the results from the systematic approach can bereproduced, the boundaries between ecological units can be revised based onnew or more accurate data, important ecological processes are explicitlychosen to delineate boundaries, and transition zones between regions can bequantified.KEY WORDS: Ecoregions; Spatial analysis; Corn Belt; Iowa; GIS;Regionalization