Asignificant Correlation Research Articles

Clinical and ultrasonographic enthesopathy in inflammatory rheumatic diseases : Is MASEI or only calcaneal enthesitis sufficient?

We aimed at investigating the ultrasonographic (US) and clinical prevalence of enthesopathy in patients with rheumatoid arthritis (RA), and axial spondyloarthropathy (SpA), as well as the correlation between this condition and disease activity, along with the quality of life. Included in the study were 30axial SpA, 21patients with RA, and 25healthy cases. Bath Anklylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Quality of Life (ASQoL), Disease activity index 28 (DAS28), and Health Assessment Questionnaire (HAQ) were used for clinical evaluation, and enthesal pain was evaluated by VAS, whereas enthesitis US evaluation was performed by using the MAdrid Sonographic Enthesitis Index (MASEI). Atotal of 152 knees, ankles, and elbow regions of all patients and controls were examined by US. Total scores of physical examination of enthesitis were 1.97± 2.68 in axial SpA, 2.43± 1.80 in RA, and 0.23± 0.12 in the control groups. No statistically significant difference was identified in the enthesitis examination between axial SpA and RA groups (p= 0.123). According to the MASEI, no significant difference was observed in quadriceps tendon enthesitis or in distal patellar ligament enthesitis between axial SpA and RA groups (MASEI3,4,5: p= 0.993, p= 0.124, p= 0.652). Aside from those points, axial SpA patients had statistically higher enthesitis scores at all MASEI enthesitis points (p< 0.05). In the axial SpA group, asignificant and positive correlation was identified between BASDAI scores and total scores of enthesitis physical examination and MASEI total scores (r= 0.739, p= 0.0001, r= 0.516, p= 0.002). Amoderately significant correlation was identified between ASQoL total scores and MASEI total scores (r= 0.466, p= 0.006), but not between the HAQ total scores and MASEI total scores (r= 0.213, p= 0.065). Compared to RA, US and clinical examination of enthesitis in patients with axial SpA should focus on the calcaneal enthesitis region. In axial SpA, ultrasonographic enthesitis is associated with impaired quality of life.

Harntraktfunktionsstörungen bei Guillain-Barré-Syndrom

Guillain-Barré syndrome (GBS) as acute inflammatory demyelinating polyradiculoneuropathy frequently leads to lower urinary tract dysfunction. The available knowledge in the medical literature is limited and good recommendations for diagnosis and therapy are rare. In this study, 189 patients with GBS were screened for lower urinary tract dysfunction. In symptomatic patients, aurodynamic study was performed. Detrusor contractility, post-void residual, and changes of the symptoms over time were studied. Overall Barthel index and urinary control Barthel index as well as the relationship of time after onset of the disease and post-void residual were studied as possible screening criteria for urodynamic assessment. According to the urinary control Barthel index (BI), 115 of 189 patients (61%) presented lower urinary tract symptoms sometime during the course of disease. In 28patients, these symptoms were temporary during the acute phase. At the time of urological assessment, 87patients had lower urinary tract symptoms. At the end of rehabilitation, 37had no symptoms anymore (BI10), 20were able to control micturition to acertain extent (BI5), and 30had no lower urinary tract control (BI0). There was asignificant negative correlation between post-void residual volume and overall BI (ρ -0.5823, p< 0.0001) and BI for urinary tract control (ρ -0.6430, p< 0.0001). Overall BI and BI for urinary tract control are suitable screening criteria for urodynamic assessment.

Assement of incapacity to work and the Mini-ICF-APP

According to recent recommendations the Mini-ICF Rating for Limitations of Activities and Participation in Psychological Disorders (Mini-ICF-APP) should be used in the assessment of incapacity to work. However evidence from empirical research in the field is missing. The application of the Mini-ICF-APP in the psychiatric assessment of 121 cases was analysed. Asignificant correlation between capacity to work and the duration of sick-leave with the Mini-ICF-APP sum-score was confirmed. The probability that criteria for disability insurance compensations was fulfilled according to the assessor increased with the Mini-ICF-APP-sum-score. Our study provides first empirical evidence regarding the application of the Mini-ICF-APP in the psychiatric assessment of incapacity to work.

PON1 L55M and Q192R gene polymorphisms and CAD risks in patients with hyperlipidemia : Clinical study of possible associations.

A decreased plasma high density lipoprotein (HDL) cholesterol level is a strong risk factor for coronary artery disease (CAD). Antioxidant activity of HDL mainly lies in the activity of paraoxonase (PON). This study aimed to investigate the relationships between PON1 L55M and Q192R polymorphisms, and the risks of CAD in patients with hyperlipidemia. From January 2014 to January 2016, 244 patients were divided into hyperlipidemia, hyperlipidemia+ CAD, and control groups. The hyperlipidemia and hyperlipidemia+ CAD groups were designated as the case group. Serum PON1 concentrations were measured using the enzyme-linked immunosorbent assay. After isolating genomic DNA, the PON1 L55M and Q192R genes were amplified by polymerase chain reaction and sequenced. In the case group, the genotypes LM and LL were detected significantly more often than in the control group, as were the alleles R (33.33%, 42.12%) and L (22.78%, 29.11%). The frequency of QR and RR genotypes was significantly higher in the hyperlipidemia+ CAD group than in the hyperlipidemia group; the allele R in the hyperlipidemia+ CAD group (42.77%) was more frequent than in the hyperlipidemia group (23.78%). The Q192R polymorphism was associated with low serum PON1 concentrations, and the lowest concentration was observed in the 192QR+ 192RR genotype (P= 0.03). Logistic regression analysis showed asignificant correlation between the 192R allele and smoking (P= 0.03), body mass index (P= 0.02), systolic blood pressure (P= 0.004), total cholesterol (P= 0.03), triglycerides (P= 0.01), HDL (P= 0.004), and low density lipoprotein (P= 0.02). The PON1 alleles 192R and 55L are associated with CAD, and the Q192R polymorphism may be arisk factor for CAD.

The Social Problems of National Poverty and Criminality in Indonesia

In the currently global challenges, the poverty is a problem faced by developing countries. An increase in the number ofpoverty is due to the impact of the global economic crisis that impact to the national crisis so that the poverty rate becomesincreasing. This research paper explores the impacts of poverty on national security and criminality. The various disabilities ofmany people in society to fulfill their basic needs such as food, education, and health, not only have a direct impact on the lowquality of life for the community, there is also an indirect effect of arising from the poverty, such as negative effect on the nationalstability of a country. Additionally, criminality is a social impact arising from poverty. Data showed that the 2015 poverty rateincreased to 11.175%, the number of criminal acts dramatically rose to 205,170 cases in Indonesia. It was found there is asignificant correlation between national poverty and criminality rate in Indonesia. Based on these data, we can conclude thatpoverty affects criminal acts.

Analysis of factors affecting the development of hypocalcaemia after multinodular goitre surgery.

Thyroidectomy is acommon surgery performed especially in treatment of multinodular goitre. The most common post-thyroidectomy complication is apostoperative hypocalcaemia, and the percentage of postoperative hypoparathyroidism could reach even 50%. Tested group and methods: Aforward-looking, randomized testing was done on agroup of 113 women being subject to multinodular goitre surgery. In this article, we wish to present an analysis of the results obtained in the control group, focusing on the predicative factors which determine the development of postoperative hypocalcaemia. Obtained results: The rate of postoperative biochemical hypocalcaemia development was significantly higher in the group of patients, where the preoperative calcium concentration was lower than 2,4 mmol/l. In that group, the development of biochemical hypocalcaemia was observed in 93,7% of cases (30 out of 32 patients), in comparison with 65,3% (17 out of 26) in the group of higher preoperative concentration of calcium. The highest risk of occurrence of postoperative hypocalcaemia was borne bythe total thyroidectomy, while the lowest one bythe subtotal thyroid lobectomy of one lobe only. Ahigher preoperative concentration of calcium in blood serum is related to the lower rate of occurrence of postoperative biochemical hypocalcaemia. However, no such correlation was revealed in the case of postoperative symptomatic hypocalcaemia. Lack of correlation was determined between the preoperative concentration of TSH and FT4 in blood serum and therate of occurrence of postoperative hypocalcaemia, both symptomatic and asymptomatic. The performed statistics did not reveal arelation between the postoperative hypocalcaemia and the duration of the surgery, but asignificant correlation was stated with the scope of the performed surgery. Revealing arelation between the rate of occurrence of postoperative hypocalcaemia and the experience of the surgeon performing the surgery was not successful.

Longer-than-average length of stay in acute heart failure : Determinants and outcomes.

Increased length of stay (LOS) during acute heart failure (HF) hospitalization is associated with readmission and mortality. The ESCAPE trial data were utilized to identify determinants and post-discharge outcomes of patients with acute systolic HF requiring longer-than-average LOS (≥7days). The study endpoints were 6‑month all-cause mortality, all-cause rehospitalization, and the composite endpoint of death, cardiac rehospitalization, and cardiac transplant. Among the 424 patients with recorded LOS, 216 (50.9%) and 208 (49.1%) had LOS≥ or <7days, respectively. Independent determinants of longer-than-average LOS included older age (OR per 10-year increase: 1.759, 95% CI: 1.120-2.763, p= 0.014), higher blood urea nitrogen (OR per 5 mg/dl increase: 1.202, 95% CI: 1.024-1.410, p= 0.024), greater inferior vena cava diameter (OR per 1 cm increase: 2.453, 95% CI: 1.175-5.121, p= 0.017), and lower sodium (OR per 4 mmol/l increase: 0.494, 95% CI: 0.268-0.911, p= 0.024). We found asignificant correlation between right-sided failure (right atrial pressure) and LOS (r= 0.229, p= 0.001) but not left-sided failure (pulmonary capillary wedge pressure, r= 0.099, p= 0.177). Patients with longer-than-average LOS had a significantly higher mortality (25.9% vs. 12%, univariate OR: 2.562, 95% CI: 1.528-4.296, p &lt; 0.001), higher all-cause rehospitalization (63% vs. 53.4%, univariate OR: 1.486, 95% CI: 1.008-2.190, p = 0.046) and higher frequency of the composite endpoint of death, cardiac rehospitalization, and cardiac transplant (61.6% vs. 45.2%, univariate OR: 1.943, 95% CI: 1.320-2.862, p= 0.001) compared with an LOS of <7days. Cox proportional hazard analysis showed that alonger-than-average LOS was an independent predictor of 6‑month all-cause mortality (HR: 1.930, 95% CI: 1.112-3.350, p= 0.019). In acute HF, right ventricular failure and renal dysfunction predict longer-than-average LOS, which is aproxy for more severe HF and is associated with worse postdischarge outcomes.

Medial olivocochlear reflex in ankylosing spondylitis patients.

Ankylosing spondylitis (AS) is achronic systemic inflammatory disease. Via autoimmune mediators, AS can damage the auditory system similar to other systems. Otoacoustic emission studies in AS patients showed that the damage that causes hearing loss was in the outer hair cells. The medial olivocochlear (MOC) reflex is used to evaluate the MOC efferent system (MOES), which includes the outer hair cells. The aim of this study was to evaluate the presence of subclinical damage in the inner ear with the aid of the MOC reflex test in AS patients with no hearing complaints. Thirty-four patients with AS and acontrol group of 30healthy volunteers with similar demographic characteristics were evaluated in the study. Otoacoustic emission responses, MOC reflex results, and frequency-specific and total suppression findings were compared between the groups. The relationship between clinical and laboratory findings for the AS patients, and the MOC reflex data were also investigated. Reduced MOC reflex response (p= 0.04) and suppression (p= 0.019) were detected in AS patients. When the clinical and laboratory findings for the AS patients and the MOC reflex test results were compared, asignificant correlation was found only between the MOC reflex and the erythrocyte sedimentation rate. The results showed that AS can damage the inner ear, especially the MOES, and can reduce the MOC reflex response without clinical hearing loss.

Prescription, Dispensation, and Generic Medicine Replacement Ratios: Influence on Japanese Medicine Costs.

This study used publicly available data to examine the effect of the separation of dispensing and prescribing medicines between pharmacists in pharmacies and doctors in medical institutions (the separation system) and the generic medicine replacement ratio on the cost of various medicines in Japanese prefectures. For Japanese medical institutions, participation in the separation system is optional. Consequently, the expansion rate of the separation system for each administrative district is highly variable. In our multiple regression analysis, the dependent variables were the costs of daily medicines, specifically, total, internal, external, and injection medicines, as well as medical devices, and the independent variables were the expansion rate of the separation system and generic medicine replacement ratio. The expansion rate of the separation system showed a significant negative partial correlation with the daily costs of total, internal, and injection medicines as well as medical devices. Moreover, the rate of replacing brand name medicines with generic medicines showed a significant negative partial correlation with the daily costs of total and internal medicines. However, external and injection medicines and medical devices did not because only a few or no generic products of these types were sold in the Japanese market. Otherwise, expansion of the separation system was effective in reducing medicine costs, except in the case of external medicines. This suggests that the cost efficiency effect of the separation system does not function all the time.

Cost Effectiveness of Erosion Control Covers during Vegetation Establishment under Simulated Rainfall

The main goal of this study was to quantify reduction of runoff responses using selected erosion control covers on 1.2 m × 0.6 m plots under simulated rainfall to determine the most cost-effective temporary cover treatment under similar soils, rainfall and embankment slope conditions. The different erosion control covers tested were polyacrylamide (PAM), wheat straw and PAM (WS + P) with and without seed; and engineered fiber matrix (EFM) with and without seed. The EFM + S and WS + P + S treatments were the most effective treatments for runoff volume with 68.0% and 48.9% reduction, respectively, as compared to control. EFM + S was the most effective treatment for turbidity and modified total suspended solids (MTSS) with 98.7%, and 99.8% reduction, respectively as compared to control. Vegetation in the wheat straw treatment significantly reduced turbidity but less effect on runoff volume and MTSS than vegetation in the EFM + S treatment. Seeded treatments combined (EFM + S, WS + P + S) had a significant negative correlation between MTSS delivery and time (r = –0.69), as compared to a positive correlation of corresponding non-seeded treatments (EFM, WS + P) over time (r = 0.14). The EFM + S treatment had 39% less average MTSS delivery than WS + P + S but the WS + P + S treatment ($1.03 kg-1 sediment reduction) was found to be 84% less expensive than the EFM + S treatment ($6.36 kg-1 sediment reduction). The WS + P + S treatment can therefore be recommended as the most cost effective method for sediment delivery reduction under similar conditions and within the limitations of this small scale plot study.

Correlation of carbonic anhydrase IX expression with clinico-morphological parameters, hormonal receptor status and HER-2 expression in breast cancer.

The hypoxia-inducible protein carbonic anhydrase IX is widely expressed in most human cancers, including breast carcinomas. CA IX attracts significant interest due to its strong association with neoplasms and its absence from corresponding normal tissues, suggesting its potential to serve as apromising diagnostic biomarker. This protein comes into the limelight also as avaluable prognostic and predictive parameter. Immunohistochemically, we examined the expression of this protein in 84 cases of invasive breast carcinoma to determinate the association with clinico-morphological and biological parameters such as age of patients, grade, stage and size of primary tumor, lymph node metastasis, vascular invasion as well as hormone receptor status and HER-2 expression. In each case, the subcellular localization of CA IX antigen, the intensity of staining and the percentage of labeled cells were assessed. Overall, CA IX was expressed in 34 cases (40.5%). The statistical analysis revealed asignificant correlation between subcellular localization of CA IX and the age of patients. Furthermore, significant correlations were also found between the grade, estrogen and progesterone status and all immunohistochemical characteristics of CA IX expression (the subcellular localization of CA IX antigen, the intensity of staining and the percentage of labeled cells). We point out that mostly membrane or combined membrane and cytoplasmic positivity together with ahigher intensity of CA IX immunoreactivity are associated with poor prognostic parameters, such as tumor grade 3 and also with negative estrogen and progesterone receptor status which may influence therapeutic approach. However, no significant correlations were shown with remaining clinico-morphological and biological parameters. We next investigate the relationship between CA IX expression in the group of invasive ductal carcinomas and the group of invasive lobular carcinomas and other less frequent types of breast carcinoma. There was, however, no significant difference. Our results suggest that moderate to strong membrane and combined membrane and cytoplasmic localization of CA IX may represent avaluable tumor biomarker as well as apromising prognostic and predictive parameter in invasive breast cancer. breast carcinoma, carbonic anhydrase IX, immunohistochemistry, clinico-morphological and biological parameters.

Non-invasive markers of atherosclerosis and their correlation with Framingham risk score in Indian patients with type 2 diabetes mellitus

Background : India has been referred as the capital of the world”. Diabetes mellitus (DM) is widely accepted as a vascular disease leading to substantive increase in cardiovascular disease (CVD). Recently, there has been much interest in the relationship between arterial stiffness and cardiovascular disease. So this study was conducted to assess the risk of atherosclerosis in patients with DM. Aim : To investigate the relationship between non-invasive oscillometric methods that assesses subclinical atherosclerosis, and Framingham Risk Score (FRS), an independent predictor of CVD, in patients with type 2 DM, and age-matched hypertensive and healthy controls. Methods : The four study groups consisted of group A I; patients with diabetes mellitus (>5 years) along with hypertension (n=55), group A II; newly diagnosed patients with DM without hypertension (n=28), group B I; patients with hypertension (n=31) and group B II; healthy controls (n=30). The participants were subjected to oscillometric measurements like arterial stiffness index (ASI), pulse wave velocity (PWV), and augmentation index (AIx). All these parameters were correlated with FRS. Results : The PWV, ASI, AIx as well as FRS of 30 yr risk of CVD were elevated in patients with DM compared to healthy controls. A significant correlation was observed between FRS, and PWV, ASI, and AIx. Conclusion : This study reveals that non-invasive oscillometric markers can be useful in early detection of early atherosclerosis in patients with type 2 DM. Key Words : Diabetes; atherosclerosis; arterial stiffness index; pulse wave velocity; augmentation index; Framingham risk score

Hubungan Shift Kerja dan Kebisingan dengan Stres Kerja Pada Karyawan Bagian Produksi Gilingan PT. Riau Crumb Rubber Factory Pekanbaru

This research aims to analyze the correlation between shift work and noise withwork stress of the workers in milling production division of PT . Riau Crumb Rubber Factory.This research is an observational analytic with cross sectional approach. The population ofthis study consists of 125 workers in milling production. With purposive sampling techniqueand using predetermined criteria obtained a total sample of 60 people. The data werecollected using work stress scale and the measurement noise by using a sound level meter andanalyzed with bivariate using the chi square test. The results showed that there was asignificant correlation between work shifts with work stress with p value (0.000) &lt; α ( 0.05 ).Employees who work on the night shift tend to have a high work stress when compared withemployees working on the morning shift and afternoon . There is a significant correlationbetween the level of noise with work stress with p value (0.000) &lt; α ( 0.05 ). The higher thenoise level the higher work stress.

Differences in the Level of Trust in Mental Health Providers among Individuals with Severe Mental Illnesses

Differences in the Level of Trust in Mental Health Providers among Individuals with Severe Mental Illnesses Anwar Khatib, Fadi Farraj Abstract Background: The study examines trust among patients with Severe Mental Illness (SMI) in mental health services providers. Study's hypothesis suggests higher level of patients' trust inthe biosocial model advocated by social workers in comparison with the biomedical model advocated by psychiatrists. Method: The study includes 60 participants (N=60), living in the community, with a history of psychiatric hospitalization. All Participants were in constant contact with psychiatrist (9 psychiatrists) and social worker (11 social workers) for a minimum period of six months.Findings: Study findings indicates that, in accordance with the hypothesis, the level of trust toward social workers was significantly higher compared to psychiatrists.In the context of the biomedical model,asignificant correlation was found between duration of contact with a psychiatrist and betweenpatient’s level of trust. Moreover,frequency of therapy sessionsfound to be the only variable predicting level of trust felt towards psychiatrists.In the context of thepsychosocial model,duration of contact, frequency of therapy sessions and number of readmissions since first hospitalization, were found to predict the level of trust felt toward social workers. Conclusions: Increasing frequency of sessions between a psychiatrist and his patient will create the essential conditions that shall allow a professionals to create a higher levels of trust among patients. In the other hand, reduced number of readmissions may retain the trust level felt toward social workers. Full Text: PDF DOI: 10.15640/ijhs.v2n4a3

The influence of selenium and zinc addition in food on concentration of these elements in blood and milk, on somatic cells number and histological characteristics of cows udders

The experiment included 30 cows of Holstein-Friesian breed, out of which 15 were receiving selenium and zinc in optimal doses before calving, while the others had never been supplemented with these micronutrients. There was analysed the concentration of selenium and zinc in blood and milk serum as well as the average number of somatic cells in corresponding lactation. After the cows exclusion from production, histological characteristics of cows udders were examined. The results of the investigation have shown that addition of selenium and zinc before calving has a positive effect on the values of these microelements in the blood and milk during the period of early lactation, that is, the concentration of these elements was significantly higher in the blood and milk of the cows that obtained selenium and zinc supplements. Also, in these cows there was significantly lower number of somatic cells during the following lacation period. In the parenchyma of the udder there was found less pronounced infiltration of leukocytes, notably thicker keratin layer of ductus papillaris and less expressed repairing processes that indicate a chronic inflammation of the udder in the samples after exclusion of the cows from production. There was a significant positive correlation between selenium in blood and milk, while there was not observed such a correlation for zinc. On the other hand, there was a significant negative correlation between the concentration of selenium in the blood and milk with the average number of somatic cells and the degree of infiltration of leukocytes, while its influence on the keratin layer of ductus papillarus was not shown. Zinc from blood and udder had a negative correlation with the number of somatic cells, had a positive correlation with the thickness of ductus papillaris keratin layer and had no influence on the level of leukocyte infiltration of udder parenchyma. Zinc demonstrates a positive influence on the formation of ductus papillaris keratin layer and protects the udder from pathogens penetration, while selenium stimulates the immunological response of the udder. Their positive impact can be defined as additive, because athough they have effect on two morphologically separate udder parts, adding both of them significantly decreases the number of somatic cells in milk.

Rhabdomyolysis Following Bariatric Surgery: a Retrospective Analysis

Background: Rhabdomyolysis (RML) indicates a skeletal muscle necrosis which results in an emission of intracellular contents from myocytes into the circulatory system. It has been recognized to be a complication of bariatric surgery. A high BMI and a prolonged operative time are the main risk factors associated to the development of RML. The aim of this study is to define the incidence and the main features of RML in a cohort of obese patients undergoing bariatric surgery. Materials and Methods: a retrospective observational analysis was carried out on 100 patients undergone bariatric surgery. The bariatric operations were open or laparoscopic Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (SG); they were performed at the university hospital Nuovo S. Chiara in 2011. Results: 6 of 100 patients enrolled developed RML. Three of these also showed acute kidney injury due to RML (50%). A significant correlation between post-operative increased creatine phosphokinase (CPK) levels and BMI was found (r=0.369; r2=0,137; p=0.005) as well as a significant correlation between the increased levels of creatine phosphokinase, myoglobin and operative time (increased operative time - highest CPK: r=0.550; r2=0.302; p&lt;0.0001; increased operative time - highest myoglobin: r=0.553; r2=0.305; p&lt;0.0001). Moreover, hypertension and prolonged operative time were found to be variables associated with RML in bivariate analysis. Conclusions: The incidence of RML following bariatric surgery was 6%. Since rhabdomyolysis is the most important complication of bariatric surgery, appropriate precautions should be taken during surgery. Post-operative monitoring of CPK and myoglobin levels is essential for an early diagnosis of RML.

HUBUNGAN ANTARA PERLAKUAN ORANGTUA DENGAN MOTIVASI BELAJAR SISWA DISEKOLAH

Parentsmust provide appropriate treatment of child development, so that children can perceive parenting provided, for motivate learning. Actually many students have not motivated to learn because of parenting. The research purpose to reveal correlation the parenting with student learning motivation. Research methods used are descriptive correlational. Result of research show parenting is quite good, student motivationis quite high andthere is asignificant correlation parenting with student motivation.

Changes in Blood Volume and Colloid Osmotic Pressure during Fluid Absorption in Patients Undergoing Endoscopic Urosurgery: An Observational Study

Background and Objective: Anesthesiologists need to be familiar with perioperative changes in blood volume (BV); however, there is no standard method for repeated evaluation of BV over a short interval of time. We evaluated BV in the operation room using repeatable estimation methods. Method: Eighty-five ASA physical status I-II patients scheduled to undergo endoscopic urosurgery using irrigation fluid under general anesthesia at Nippon Medical School Hospital were included in this study. Irrigation with 3% sorbitol in water was commenced after establishment of general anesthesia and volumetric fluid balance, which was defined as control water balance (WB). Hematocrit (Hct), colloid osmotic pressure (COP), total protein (TP) and albumin (Alb) were repeatedly determined before and during anesthesia. BV was calculated using Allen’s formula and the changes in Hct, COP, TP and Alb. Main Outcome Measures: The main outcome was the accuracy of measuring changes in BV (△BV) calculated using the four serum markers. WB and the estimated △BV calculated from Hct, COP, TP and Alb (△BV-Hct, △BV-COP, △BV-TP, and △BV-Alb) were analysed using Pearson’s correlation coefficient test and Bland-Altman analysis. Results: Sixty-five patients were excluded. In the remaining 20 patients, there was a significant correlation between WB and △BV-COP (R2 = 0.72; P △BV-TP (R2 = 0.59; P △BV-Alb (R2 = 0.57; P △BV-Hct (R2 = 0.06). Conclusion: △BV-COP, △BV-TP and △BV-Alb had correlation with WB. However, since COP can be measured repeatedly with simplified instruments under selected clinical circumstances, while TP and Alb cannot. COP is the most useful marker to measure △BV during perioperative period. Hct does not allow precise estimation of △BV.

Alternating sleeping arrangements as a coping strategy for snorers and their bed partners—A prospective study

Background: Despite overwhelming evidence for gender differences in sleep quality as well as gender-specific changes of sleep parameters with respect to habitual sleeping arrangements, studies on snorers and their bed partners have ignored the influence of individual quality of sleep as a potential co-factor. Objective: The objective of this study was to record subjective and objective sleep parameters and to analyze the effects of alternating of sleeping arrangements in snorers and their bed partners. Methods: Habitual snorers and their bed partners were recruited via newspaper articles not stating the exact purpose of the study. Both filled out a 90-day sleep diary. During this time, we recorded subjective and objective sleep parameters in the snorers and their bed partners via wrist actigraphy and sleep diaries for 14 days. For statistical analysis, we used two-sided t-tests and Spearman’s Rho. Results: The dataset included 45 snorers (11 females) and 45 bed partners (34 females) with a mean age of 47 ± 13 and 43 ± 12 years. Screening for sleep apnea yielded snoring without OSAS, mild-, moderate- and severe OSAS in 27 (60%), eight (18%), three (7%) and six (15%) snorers. PSQI total scores were significantly lower in snorers than in bed partners (4 ± 2 vs. 6 ± 4, p = 0.002). We could not find a significant correlation between subjective and objective sleep latency and efficiency. Couples who changed their sleeping arrangement were significantly younger than those who habitually slept alone or together (p = 0.01). Subjective sleep parameters of snorers or bed partners were not related to the number of consecutive nights spent either together or apart. Conclusions: Our study confirmed the weak correlation of subjective and objective sleep parameters in pairs with snoring problems. Couples changing their sleeping arrangement were the youngest among the whole group, but their separation of sleeping arrangements did not improve subjective sleep parameters.

The prognostic value of MMP-9 expression in lung adenocarcinoma

Background: The increased expression of MMPs in tumor cells is considered immportant for invasive tumor growth and metastatic potential. The aim of the study was to analyze the expression level of matrix metalloproteinase 9 (MMP-9) in tumor cells, estimate the prognostic value of MMP-9 expression, and correlate the MMP-9 expression to histopathological characteristics of the tumor and the disease stage. Methods: In this study, 107 patients with operable lung adenocarcinoma were examined, including the information obtained in a five-year follow-up. The expression of MMP-9 was determined in paraffin-embedded tissue specimens by immunohistochemical analysis. Results: The research was performed in the patients who underwent a surgery for the removal of lung adenocarcinoma. The patients were divided into three groups based on the stage of the disease: stage I - diagnosed 54 (50.46%) stage II - 30 (28.04%) and stage IIIA - 23 (21.50%) patients. In the total sample, MMP-9 positivity was established in 61 (57.01%) patients, while 46 (42.99%) patients were negative or slightly positive. MMP-9 expression was registered in the disease stage I group, established as positive or negative MMP-9 expression in 27 (50.00%) patients, respectively. In stage II disease group, 17 (56.67%) patients had MMP-9 positive tumors and 13 (43.33%) had MMP-9 negative tumors. In 17 (73.91%) patients of the stage IIIA group, MMP-9 positivity was confirmed in the tumor tissue, while 6 (26.09%) had negative or low MMP-9 expression in tumor cells. The log rank analysis showed a significant correlation of a poor survival, higher disease stage (p=0.022), and high MMP-9 expression in tumor cells (p=0.002). Conclusion: The study showed that the positive expression of MMP-9 was present in a large number of patients with advanced disease stages. The patients with lung adenocarcinoma who expressed higher MMP-9 levels had shorter survival periods compared to the patients with low MMP-9 expression.