Results Of Biochemical Tests Research Articles

Effects of Malted Rice Amazake Consumption on Nutritional Status and Gut Microbiome in Older Patients and Residents of an Integrated Facility for Medical and Long-Term Care

Malnutrition is observed in approximately 20–50% of hospitals and long-term care facilities. We examined the effects of malted rice amazake beverage on the nutritional status and gut microbiome of older patients and residents in an integrated long-term care facility; 13 older patients and residents (84.6 ± 9.3 years) were prescribed 35 g of malted rice amazake daily for six weeks. Gut microbiome analysis, body composition and blood biochemistry test results, defecation surveys, dietary intake, and medications were recorded before and after the intervention. After the intervention, the Geriatric Nutritional Risk Index (GNRI) increased from 83.6 ± 9.1 points to 86.0 ± 9.8 points, and serum albumin increased from 3.3 ± 0.5 g/dL to 3.4 ± 0.5 g/dL. The α-diversity of gut bacteria increased from 390.1 ± 89.4 before to 447.2 ± 108.1, and the abundance of Desulfovibrio decreased from 0.76 ± 0.47% to 0.56 ± 0.60%. ΔGNRI showed a positive correlation with ΔBifidobacterium and ΔBarnesiella, but a negative correlation with ΔKlebsiella. Consumption of malted rice amazake for six weeks improved the GNRI and altered the gut microbiome of older patients and residents at moderate risk of nutritional disorders. Malted rice amazake may be a new way to improve nutrition because it has a high nutritional value, mainly in terms of carbohydrates, and improves the gut microbiome.

Comparison of the Hemolysis Rate According to Biochemistry Test Results of Patients Admitted to The Emergency Department with the Results of the Hemcheck Device

Comparison of the Hemolysis Rate According to Biochemistry Test Results of Patients Admitted to The Emergency Department with the Results of the Hemcheck Device

Analiza biohemijskih faktora u serumu koji utiču na rano neurološko pogoršanje kod pacijenata sa ishemijskim moždanim udarom i razvoj nomograma predikcionog modela

Background: To investigate the risk factors associated with early neurological deterioration (END) in ischemic stroke (IS) patients and develop a predictive nomogram model. Methods: General clinical data from 220 IS patients treated between December 2022 and November 2023 were collected for observation. The study's inclusion and exclusion criteria select patients aged 18+ with a first-time diagnosis of IS who undergo lab tests within 24 hours of admission while excluding those with multiple organ dysfunction, sensory impairments, coagulation disorders, or other serious medical conditions. Based on the National Institutes of Health Stroke Scale (NIHSS) in the United States, patients were categorized into two groups: END (n=69) and non-END (n=151). Both groups' basic demographics, medical history, and biochemical test results were compared. Influencing factors were identified using the least absolute shrinkage and selection operator (LASSO) method, and these variables were included in a multivariate logistic regression analysis to construct a nomogram for predicting END in IS patients. Model performance was evaluated using internal validation with the Bootstrap method, assessing discrimination, calibration, and clinical validity. Results: Factors such as history of diabetes, fasting plasma glucose (FBG), triglyceride (TG), homocysteine (Hcy), and C-reactive protein (CRP) were identified as single factors for early functional deterioration in IS patients (P<0.05). A logistic regression model was established with END as the dependent variable and significant single factors (P<0.05) as independent variables. The results indicated that diabetes history (OR=1.398, P=0.301), TG (OR= 6.149, P<0.05), ASPECT score (OR=7.641, P<0.05), FBG (OR=2.172, P<0.05), CRP (OR=1.706, P<0.05), NIHSS score 7 days post-admission (OR=1.336, P<0.05), and Hcy (OR=1.425, P<0.05) were independent risk factors for END in IS patients (P<0.05). ROC analysis showed an ASPECT area under the curve of 0.910 (95% CI:0.864 to 0.944), with 84.06% sensitivity and 86.09% specificity. Hcy had an area under the curve of 0.808 (95% CI:0.750 to 0.858), with 79.71% sensitivity and 70.20% specificity. FBG had an area under the curve of 0.847 (95% CI:0.793 to 0.892), with 69.57% sensitivity and 95.36% specificity. TG had an area under the curve of 0.937 (95% CI: 0.896-0.965), with 91.30% sensitivity and 82.78% specificity. NIHSS had an area under the curve of 0.857 (95% CI: 0.803-0.900), with 89.86% sensitivity and 70.20% specificity. A nomogram model for END risk prediction was constructed based on the logistic regression analysis results, assigning preliminary scores for each of the 9 predictive factors. The total score, ranging from 0-100 points, was used to predict END risk in patients (0-100%). The constructed nomogram model showed that ASPECT was 59.2, Hcy was 84.0, FBG was 61.4, TG7.0 mmol/L was 39.4, and NIHSS was 98.1 with a total score of 345.7 which predicted the risk of END at 68.9%. Conclusions: ASPECT, Hcy, FBG, TG, and NIHSS are independent factors influencing END after IS. On this basis, a visual predictive nomogram model is constructed to predict the risk of END in patients accurately.

Treatment of secondary hemophagocytic syndrome

Introduction. Hemophagocytic syndrome (HPS) is a reaction of severe, excessive, but ineffective inflammation. HPS is divided into primary or as a complication of a different causes — secondary HPS (sHPS).Aim: to analyze the effi cacy of different treatments in sHPS patients.Materials and methods. For the retrospective analysis, the medical documentation of patients who were treated in the period from June 2009 to January 2023 was used. The H-Score and HLH-2004 criteria were used to verify sHPS. The results of clinical blood analysis and biochemical tests are presented. The survival was analyzed within two weeks after the verification of sHPS. The main treatment options for sHPS were etoposide, glucocorticosteroids (GCSs), anticancer therapy and intravenous immunoglobulin.Results. The study included data from 130 patients, median age 56 years (18–90); 70 females and 60 males with sHPS. All patients received treatment with a drug change in cases of inefficiency: a total of 186 episodes. A stable response was achieved in 74 (56.9 %) patients. The median survival in patients without a response was 2 days. If the therapy was effective, the median survival was not reached. Positive dynamics were observed during the first day after the start of effective treatment, however, a few patients had transient worsening of some markers. The main factor in the negative prognosis was the degree of multiple organ failure during sHPS verification. In the group of patients with autoimmune diseases, GCSs were the most effective, with a response reached in 75 % of cases. For patients with resistance, as well as in patients with Epstein—Barr virus infection and blood malignancy, etoposide proved to be effective in 65.7 % of cases.Conclusion. sHPS was accompanied by an increase in pancytopenia, cytolytic, cholestatic syndromes, hypocoagulation, azotemia, hypertriglyceridemia and excessive hyperferritinemia. After the initiation of effective therapy, persistent clinical and laboratory responses developed during the first day. Therapy by GCSs was effective in most patients with autoimmune diseases associated with sHPS. With other forms of sHPS in the studied group, etoposide had the most pronounced effect.

Improved Point-of-Care Mass Spectrometry Analysis with Thin-Layer Chromatography-Based Two-Dimensional Separation and Spray Ionization.

Point-of-care testing (POCT) involves administering rapid on-site analysis to provide fast biochemical testing results. POCT reduces delays in clinical decision-making and eliminates the need to transport and prepare clinical samples for immediate diagnosis or clinical intervention by healthcare professionals. Herein, a novel methodology integrating thin-layer chromatography-based two-dimensional separation with miniature mass spectrometry was developed for rapid on-site clinical analysis. As a proof-of-concept demonstration, γ-aminobutyric acid, 2-hydroxyglutarate, and N-acetyl-l-aspartic acid, which are widely known as biomarkers for brain gliomas, were selected as model analytes for method development and validation. The proposed approach exhibited satisfactory analytical performance, with 1 ng/mL limits of detection, 2 ng/mL limits of quantitation, and recoveries in the range of 85.9-107.2%. Additionally, on-TLC derivatization and reactive spray ionization strategies were utilized to enhance the mass spectrometric signals compared to underivatized analysis. This method was applied to analyze clinical samples, showcasing its attractive potential outside the laboratory.

Toxicity And Antioxidant Activities of Endophytic Bacteria from Butterfly Pea (<i>Clitoria ternatea</i> Linn.)

Endophytic bacteria are bacteria that live in healthy plant tissues without causing damage. Several studies have reported that endophytic bacteria can produce active compounds similar to those secreted by their host and which potentially have medicinal value. Butterfly pea (Clitoria ternatea L.) was noted to be able to produce antioxidants and have toxicity potential from its compounds. Therefore, endophytic bacteria from butterfly pea have great potential to have antioxidant activity along with evaluating the toxicity level of the selected bacteria. This study aimed to determine the number of isolates, to characterize, and test the toxicity and antioxidant activities of endophytic bacteria from butterfly pea. Toxicity level was tested using the Brine Shrimp Lethality Test (BSLT) method while levels of antioxidants were tested using the DPPH (1,1-diphenyl-2-picrylhydrazyl) method. A total of fifteen endophytic bacteria were obtained and successfully purified. Based on the morphological observations, Gram staining, and biochemical test results, isolate EBT13 was determined to belong to the genus Bacillus. Isolate EBT13 was categorized as highly toxic, with the highest toxicity value with other bacterial isolates with an LC50 of 84 ppm and antioxidant activity with an IC50 value of 44.32 ppm. Based on the phylogenetic tree of 16S rRNA gene analysis, EBT13 belongs to the genus Bacillus, it forms a sister group with Bacillus pumilus with a bootstrap value of 100%. This study advances our knowledge of plant-microbe interactions by identifying a highly toxic, antioxidant-producing strain of bacteria of butterfly pea. The results have significance for the development of cytotoxic chemicals and natural antioxidants, which could advance biotechnological research and boost therapeutic purpose.

Evaluation of urine protein to creatinine ratio in sighthound breeds.

The breed can influence the results of haematological and biochemical blood tests, with sighthounds traditionally mentioned. It may also affect certain urinary parameters. This study aimed to compare urinary protein and creatinine concentrations and their ratio (UPC, urine protein to creatinine ratio) between sighthounds and non-sighthounds and to evaluate these parameters in various sighthound breeds. Urine samples from clinically healthy dogs were collected via normal voiding, representing both sighthound and non-sighthound breeds. The protein and creatinine concentrations in the urine samples were determined, and their ratio was subsequently calculated. A total of 191 urine samples from sighthounds and 90 urine samples from non-sighthound breeds used as a control group were evaluated in the study. In sighthounds, significantly lower urinary protein concentration (248.8 mg/l and 299.8 mg/l, respectively; P = 0.045) and significantly higher urinary creatinine concentration (23.0 mmol/l and 17.5 mmol/l, respectively; P = 0.000) and lower UPC values (0.13 and 0.18, respectively; P = 0.000) were observed in comparison to the entire control group. The UPC values were found to be significantly lower in Greyhounds and Spanish Greyhounds compared with non-sighthounds. Although statistically significant changes were identified, they are unlikely to be of great clinical importance.

Cardiovascular problems in rabbits in reference to hypothyroidism - a four-year retrospective study.

The effects of T4 are mainly manifested by positive ino- and chronotropism. The syndrome accompanying hypothyroidism in rabbits (impaired myocardial contractility and reduced ejection capacity) is caused by a deficiency of thyroid hormones - especially T4. The study group consisted of a total of 41 animals: 15 males and 26 females, ranging in age from 2 months to 8 years, with echocardiogram showing reduced fractional shortening (<30%), with normal results of heamatological and biochemical tests. Blood was collected in order to measure T4 level. Echocardiographic examinations were performed with two-dimensional (2D) imaging, M-mode measurements and the pulsed/colour-labelled Doppler technique. Statistical analysis was performed using Statistica 13.0. Correlations were determined: between serum thyroxine concentration and the value of the fraction of shortening in the groups: young animals (up to 5 years of age) and older animals, females and males, and sterilised and non-sterilised animals. Statistical analysis showed a positive correlation between T4 levels in the blood of the test animals and myocardial fractional shortening and heart rate and left-atrial to aortic ratio (LA/Ao) in the pre-treatment period. A positive correlation was also shown after dividing the patients into 2 groups based on their age (below 5 years vs. 5 years and over), sex (male and female rabbits) and fact of sterilization (yes/no). Our study unequivocally confirmed a positive correlation between the decreased serum T4 concentration and reduced fractional shortening, indicating decreased cardiac systolic function in hypothyroid rabbits.

Optimal frailty assessment tool for elderly patients with heart failure based on outcome prediction: protocol for a multicentre prospective cohort study

IntroductionFrailty significantly influences the prognosis of elderly patients diagnosed with heart failure. The assessment of frailty is a critical initial step in the management of these patients, as a systematic...

Caring for Patients With Pheochromocytomas in the Perioperative Setting: Earn 1.4 Contact Hours.

Pheochromocytomas are rare, complex catecholamine-secreting tumors of the adrenal medulla. Patients with pheochromocytomas may experience episodes of life-threatening hypertension, and untreated tumors can be fatal. The nonspecific signs and symptoms (eg, headaches, palpitations, sweating) make diagnosing these tumors difficult. A comprehensive patient history, clinical evaluation during episodic hypertension, and biochemical test results can facilitate a definitive diagnosis. The only curative treatment is minimally invasive tumor removal. Because the tumor may recur, patients require follow-up visits for approximately 10years after surgery. Preoperative evaluations can include cardiac and imaging studies and genetic testing. Preoperative preparation involves controlling hypertension and planning for hypotension after tumor removal. Perioperative nurses should be prepared to assist anesthesia professionals with placing invasive hemodynamic monitors and responding to blood pressure changes. An interdisciplinary team can create a guideline or protocol for nurses to follow to enhance outcomes when caring for patients with pheochromocytomas.

Comparative assessment of the most important markers of equine myopathy in connection with creatine kinase activity

Purpose: to assess the activity of AST, LDH and HBDH enzymes in relation to different levels of total creatine phosphokinase activity to understand the degree of their diagnostic value in determining the severity of myopathy in horses.Materials and methods. For the study, statistical processing of a data array of the results of a biochemical study of blood serum from 247 horses was carried out. Taking into account the reference intervals of CPK activity, all results were ranked by increasing creatine phosphokinase activity and divided into four groups. In each group, the average values for AST, LDH and HBDH were calculated, and the degree of significance of intergroup differences was calculated using the Student's t test. The correlation between the activity of the enzymes AST, LDH and HBDH with the activity of CPK in each group was also assessed.Results. An increase in the activity of creatine phosphokinase in horses by 59,4—409,6 % is accompanied by an increase in the activity of the enzymes AST by 14,5—77,2 %, LDH by 17,8—33,0 % and HBDH by 17,1—27,1 %. When comparing Pearson's correlation coefficients across the entire study sample, a significant direct relationship is determined between CPK and AST and a moderate direct relationship when comparing CPK with LDH and HBDH. Calculation of the Pearson coefficient in each of the studied groups showed different degrees of correlation between the creatine phosphokinase indicator and other enzymes, but in all cases positive. A study of the percentage contribution of HBDH to the total lactate dehydrogenase activity showed an inversely proportional relationship with respect to the activity of creatine phosphokinase, which indicates massive muscle damage with switching energy metabolism in them.Conclusion. The conducted studies made it possible to more deeply understand the cause-and-effect relationships of changes in the activity of enzymes that are specific to muscle tissue in connection with the severity of myopathy. The data obtained can assist veterinary specialists in analyzing the results of biochemical blood tests in horses.

Physiological and biochemical assessment of a new three-breed carp cross

The article presents data about the physiological and biochemical assessment of a new three-breed carp cross. The basis for the creation of the cross was the theory of heterosis and the high combinational ability of both parent forms. The effect of heterosis was noted for a number of zootechnical indicators: body weight, head index, number of stamens on the anterior gill arch. The results of a comparative analysis of biochemical parameters such as alanine aminotransferase activity, glucose and total protein content are presented, which allowed us to conclude about the physiological state of the new three-breed cross, about the balance of its carbohydrate metabolism and high rates of protein metabolism, low level of hepatocyte destruction, high immune status and cellular immunity. The new cross is characterized by intensive metabolism of a greater proportion of mature neutrophils and a high level of cellular immunity according to the cytochemical coefficient of lysosomal cationic protein. When obtaining a new three-breed cross, the method of reciprocal hybridization of different carp breeds was used and the choice of an acceptable option with a pronounced effect of heterosis in terms of productivity and vitality was used. The article presents the results of immunological, hematological and biochemical blood tests of the new cross. Also, the article demonstrates the results of studies of the phagocytic activity of neutrophils and determines the content of non-enzymatic cationic protein in them. According to the results of the biochemical assessment, the new three-breed cross showed a high combination of its parent forms with the expected level of the heterosis effect.

Nutritional Modulation of the Gut-Brain Axis: A Comprehensive Review of Dietary Interventions in Depression and Anxiety Management.

Mental health is an increasing topic of focus since more than 500 million people in the world suffer from depression and anxiety. In this multifactorial disorder, parameters such as inflammation, the state of the microbiota and, therefore, the patient's nutrition are receiving more attention. In addition, food products are the source of many essential ingredients involved in the regulation of mental processes, including amino acids, neurotransmitters, vitamins, and others. For this reason, this narrative review was carried out with the aim of analyzing the role of nutrition in depression and anxiety disorders. To reach the review aim, a critical review was conducted utilizing both primary sources, such as scientific publications and secondary sources, such as bibliographic indexes, web pages, and databases. The search was conducted in PsychINFO, MedLine (Pubmed), Cochrane (Wiley), Embase, and CinAhl. The results show a direct relationship between what we eat and the state of our nervous system. The gut-brain axis is a complex system in which the intestinal microbiota communicates directly with our nervous system and provides it with neurotransmitters for its proper functioning. An imbalance in our microbiota due to poor nutrition will cause an inflammatory response that, if sustained over time and together with other factors, can lead to disorders such as anxiety and depression. Changes in the functions of the microbiota-gut-brain axis have been linked to several mental disorders. It is believed that the modulation of the microbiome composition may be an effective strategy for a new treatment of these disorders. Modifications in nutritional behaviors and the use of ergogenic components are presented as important non-pharmacological interventions in anxiety and depression prevention and treatment. It is desirable that the choice of nutritional and probiotic treatment in individual patients be based on the results of appropriate biochemical and microbiological tests.

Severe hydronephrosis complicated with primary aldosteronism: a case report and review of the literature

BackgroundPrimary aldosteronism is characterized by high plasma aldosterone and low renin. The plasma aldosterone-to-renin ratio is recommended for screening. Severe hydronephrosis leads to renal parenchymal ischemia, resulting in increased renin secretion. Since nonsuppression of renin may cause a negative result in the aldosterone-to-renin ratio test, severe hydronephrosis and primary aldosteronism occurring simultaneously in a patient are challenging to diagnose.Case presentationA 54-year-old Chinese man of Han ethnicity was diagnosed with hypertension and severe hypokalemia (minimum 1.57 mmol/L) 13 years prior, and was also diagnosed with severe hydronephrosis due to congenital ureteral stenosis on the left side. His clinical features suggested primary aldosteronism, but the aldosterone-to-renin ratio result of the patient was negative every time he underwent the primary aldosteronism screening test. No further treatment for primary aldosteronism was performed, which led the patient to suffer from severe hypokalemia, such that he was taking 12–15 g/day potassium chloride orally to keep his blood potassium between 3.0 and 3.5 mmol/L (reference value, 3.5–5.5 mmol/L) for 13 years, and the patient needed to be hospitalized in the intensive care unit for rescue several times. At admission, although the aldosterone-to-renin ratio result of the patient was negative, we still did the saline stress test and captopril inhibition test, and the results showed that the plasma aldosterone level was not lower after the test than before the test. Adrenal enhanced computed tomography suggested an adenoma in the left adrenal gland, and the results of adrenal vein sampling suggested that the left side was the dominant side. Therefore, laparoscopic total resection of the left adrenal gland was performed, and 2 weeks later, the patient developed short-term renal function impairment and hyperkalemia, but his renal function and blood potassium returned to normal after treatment that included fluid rehydration. The patient’s biochemical test results and clinical symptoms were completely normal after 1 year.ConclusionWe suggest that for patients with a high suspicion of primary aldosteronism in the clinic, comprehensive analysis must be performed in combination with clinical characteristic assessments, such as severe hydronephrosis, if renin is within the normal range or if the aldosterone-to-renin ratio result is negative at screening and diagnostic tests, and adrenal vein sampling should be performed if necessary. It can help avoid misdiagnoses and contribute to the treatment of patients with severe hydronephrosis and primary aldosteronism.

8737 Primary Hyperparathyroidism (PHPT) “Phenotypes” and the Results of Parathyroid [99mTc]Tc-Sestamibi SPECT/CT Scintigraphy: Minimizing the Risk of Negative Imaging Results

Abstract Disclosure: K. Kucharczyk: None. A. Drynda: None. J. Podlewski: None. M. Trofimiuk-Muldner: None. A. Hubalewska-Dydejczyk: None. Introduction. Primary hyperparathyroidism (PHPT) is a prevalent endocrinopathy typically identified through biochemical testing. PHPT is characterized by hypercalcemia accompanied by increased or inappropriately normal plasma parathyroid hormone (PTH) concentrations. Preoperative imaging is conducted when surgery is indicated to pinpoint parathyroid adenomas. [99mTc]Tc-Sestamibi scintigraphy is highly specific and sensitive in diagnosing PHPT, with a higher adenoma detection rate demonstrated for patients with larger lesions or higher blood calcium concentrations. The study aimed to investigate the relationship between the results of biochemical tests and clinical manifestations (PHPT “phenotype”) and the rate of positive results of parathyroid [99mTc]Tc-Sestamibi scintigraphy. Materials and methods. This was a retrospective study of patients suspected of PHPT who underwent parathyroid [99mTc]Tc-Sestamibi SPECT/CT scintigraphy between 2010 and 2022. Patients’ cluster analysis was conducted based on PTH, serum calcium (Ca), and phosphate (Pi) concentrations to find distinct patterns in these parameters. Furthermore, we compared the distributions of additional patients’ attributes, including gender, lesion size, serum vitamin D, ALP concentrations, urinary calcium, urolithiasis prevalence, as well as parathyroid scintigraphy results. Results. 513 patients were divided into 5 clusters using different algorithms. Finally, clusters from K-means methods were selected based on statistical metrics and expert interpretation. Those were organized in ascending order of positive scintigraphy results, with Cluster 5 reaching a 79.5% positivity rate and median values of PTH - 315.5 pmol/L, Ca - 2.96 mmol/L, and Pi - 0.7 mmol/L. As the proportion of positive imaging outcomes declined, median PTH and calcium concentrations decreased while phosphate concentrations increased. In Cluster 1, with 30% of positive imaging results, medians were as follows: PTH - 79.06 pmol/L, Ca - 2.55 mmol/L and Pi - 1.1 mmol/L. A comparative analysis of various clinical and biochemical parameters revealed statistically significant differences between clusters. Patients from Clusters with a higher frequency of positive scintigraphy were significantly more likely to be males, vitamin D deficient, with higher ALP concentrations, diagnosed with urolithiasis, and harbouring larger lesions. Conclusions. PHPT “phenotypes” correlated with disease severity are evidently linked to parathyroid scintigraphy detection rate. Therefore, it is crucial to know that false-negative imaging is more likely in PHPT patients with minor deviations in laboratory tests. Judicious assessment of biochemical and clinical features may limit the number of redundant parathyroid scintigraphies and, in consequence, reduce healthcare costs and unnecessary radiation exposure. Presentation: 6/2/2024

12397 Predictors Of Hospital Readmission Within Three Months Among Patients Admitted For Diabetic Ketoacidosis (dka)

Abstract Disclosure: O. Onwudiwe: None. L. Yerashevich: None. C. Onwudiwe: None. B. Baral: None. A. Acharya: None. H. Nguyen: None. Purpose: Diabetic ketoacidosis (DKA) represents a critical, life-threatening complication of diabetes, with higher rates of re-admission noted among individuals from lower socioeconomic backgrounds, those lacking insurance coverage, and those with suboptimal follow-up care. This study seeks to identify predictors of hospital readmission within three months among patients admitted for DKA in a community hospital setting. Methods: Patient data were extracted from electronic medical records from 2019 to 2021 for individuals admitted due to DKA using ICD codes. DKA diagnosis was based on the presence of hyperglycemia, high anion gap metabolic acidosis, and ketonemia. Demographic information, results of routine biochemical tests, insurance status, follow-up with primary care providers (PCP) or endocrinologists, and clinical progression were retrospectively collected from patients' records. Multivariable logistic regression analyses were conducted to identify predictors of readmission. Results: A total of 222 unique DKA admission visits were analyzed. The mean age (standard deviation) of the patients was 48 (16) years, and 58% of them were male. Among these visits, 39% had type 1 diabetes, 43% had type 2 diabetes, and 18% were newly diagnosed diabetes cases. The majority of patients were overweight, with a mean body mass index (BMI) of 27, and the mean glycated hemoglobin level was 10.8. Common triggers for DKA included insulin non-adherence (52%), infection (37.8%), and alcohol use (8.6%). Logistic regression analysis revealed that lack of follow-up significantly increased the odds of readmission within three months (B = 2.025, p = .003, Exp(B) = 7.576, 95% CI [1.952, 29.401]), as did having type 1 diabetes (B = 1.473, p = .019, Exp(B) = 4.364, 95% CI [1.272, 14.978]). However, the association between insulin adherence and readmission was not statistically significant at the conventional alpha level of 0.05 (B = 1.329, p = .112, Exp(B) = 3.777, 95% CI [0.733, 19.458]). Other demographic (age, gender, employment status, insurance status, medication compliance,) and clinical [insulin adherence, presence of infection, blood glucose level at diagnosis of DKA, and level of glycated hemoglobin (Hba1c)] variables did not significantly predict readmission within 3 months. Conclusion: DKA, being preventable with adequate insulin adherence, is also influenced by factors such as infection and lifestyle choices. The findings highlight the critical role of post-discharge follow-up care in reducing readmission rates among DKA patients. Healthcare providers should prioritize ensuring timely and comprehensive follow-up, particularly for patients with type 1 diabetes, to optimize post-hospitalization management and prevent avoidable readmissions. Presentation: 6/3/2024

Evaluation of Body Composition and Biochemical Parameters in Adult Phenylketonuria

Background/Objectives: Phenylketonuria is a hereditary metabolic disorder characterized by a deficiency of phenylalanine hydroxylase. The main treatment for PKU is a phenylalanine-restricted diet. The exclusion of protein rich natural foods and inclusion of low-Phe substitutes may give rise to an imbalanced diet, and the increased risk of overweight and obesity in PKU is a cause for concern. We aimed to evaluate the body composition and nutritional biochemical biomarkers in adult PKU patients who are on Phe-restricted and essential amino acid-supplemented nutrition therapy and to investigate the relationships between these parameters and patient gender, adherence to dietary therapy, and disease type, defined as mild or classic PKU. Methods: The study group comprised 37 PKU patients and 26 healthy siblings as controls. The participants were assessed based on an analysis of anthropometric parameters, body composition, and biochemical test results. Results: PKU patients do not have a higher incidence of overweight and obesity than healthy controls, the proportion of energy derived from carbohydrates in their diets was below the recommended level, and their total energy intake was below the recommended daily allowance. It was remarkable that patients with a treatment adherence ratio of &lt;50% displayed a higher prevalence of overweight and abdominal obesity in comparison to those with a more favorable treatment adherence ratio. Conclusions: In view of the growing prevalence of overweight in the general population, PKU patients should be kept under close long-term follow-up. Particularly in the group with low treatment compliance, more caution should be taken in terms of adverse outcomes.

Preoperative electrocardiogram in prediction of 90-day postoperative mortality: retrospective cohort study

BackgroundThere are conflicting data on the relationship between preoperative electrocardiogram and postoperative mortality. We aimed to assess the predictive value of preoperative ECG on postoperative all-cause mortality in patients undergoing non-cardiac surgery (NCS).MethodsWe retrospectively reviewed records of hospitalized patients who underwent an internal preoperative examination and subsequent NCS in the years 2015–2021. We recorded patient comorbidities, vital functions, results of biochemical tests, ECG. The primary end point was 90-day postoperative all-cause mortality, acquired from the hospital records and the nationwide registry run by the Institute of Health Information and Statistics of the Czech Republic.ResultsWe enrolled a total of 2219 patients of mean age 63 years (48% women). Of these, 152 (6.8%) died during the 90-day postoperative period. There were statistically significant associations between increased 90-day postoperative all-cause mortality and abnormal ECG findings in resting heart rate (≥ 80 bpm, relative risk [RR] = 1.82 and ≥ 100 bpm, RR = 2.57), presence of atrial fibrillation (RR = 4.51), intraventricular conduction delay (QRS > 0.12 s, RR = 2.57), ST segment changes and T wave alterations, left bundle branch hemiblock (RR = 1.64), and right (RR = 2.04) and left bundle branch block (RR = 4.13), but not abnormal PQ and QT intervals, paced rhythm, incomplete right bundle branch block, or other ECG abnormalities. A resting heart rate (≥ 80 bpm, relative risk [RR] = 1.95 and ≥ 100 bpm, RR = 2.20), atrial fibrillation (RR = 2.10), and right bundle branch block (RR = 2.52) were significantly associated with 90-day postoperative all-cause mortality even in subgroup of patients with pre-existing cardiac comorbidities.ConclusionsPatients with abnormal preoperative ECG findings face an elevated risk of all-cause mortality within 90 days after surgery. The highest mortality risk is observed in patients with atrial fibrillation and left bundle branch block. Additionally, an elevated heart rate, right bundle branch block, and atrial fibrillation further increase the risk of death in patients with pre-existing cardiac conditions.

Evaluation of indirect indices in the insulin resistance assessment in patients with different body mass index

Introduction: Insulin resistance (IR) is a complex pathophysiological condition with multifactorial etiology characterized by a reduced responsiveness of target tissues to insulin (INS). Indirect indices based on mathematical models and derived from laboratory parameters have become increasingly popular in the past two decades. In this study, we evaluated their ability to predict IR in a population with different body mass index (BMI). Methods: The matched case–control study was conducted in 2021 and 2022. Secondary data from 129 subjects were obtained from medical records, including demographic characteristics, anthropometric measurements, and biochemical laboratory test results. The studied group consisted of 91 subjects with a suspected diagnosis of IR who were further categorized according to BMI, while control group consisted from 38 age- and gender-matched subjects. Six widely used indirect indices were calculated: Homeostatic Model Assessment for IR (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), McAuley index (MCAi), metabolic score for IR (METS-IR), triglyceride to glucose index (TyG), and TyG to BMI (TyG-BMI). Results: Significant differences between the subgroups were found in the mean values for HOMA-IR, TyG, TyG-BMI, and METS- IR, while the control group had the highest mean values for the indirect indices QUICKI and MCAi (p &lt; 0.001). HOMA-IR, TyG, and TyG-BMI showed statistical significance in predicting IR regardless of BMI (p &lt; 0.05). In the obese group, TyG-BMI had good predictive power for discriminating IR (area under the curve [AUC] = 0.820), with a sensitivity and specificity of 84.1% and 87.7%, respectively. HOMA-IR showed moderate predictive power to discriminate IR in the obese group (AUC = 0.720), with a sensitivity and specificity of 70.4% and 89.1%, respectively. Conclusion: As IR is a multifactorial disease, indirect indices combining laboratory and anthropometric data can significantly help in predicting and mitigating complications.

Study on risk factors of impaired fasting glucose and development of a prediction model based on Extreme Gradient Boosting algorithm.

The aim of this study was to develop and validate a machine learning-based model to predict the development of impaired fasting glucose (IFG) in middle-aged and older elderly people over a 5-year period using data from a cohort study. This study was a retrospective cohort study. The study population was 1855 participants who underwent consecutive physical examinations at the First Affiliated Hospital of Soochow University between 2018 and 2022.The dataset included medical history, physical examination, and biochemical index test results. The cohort was randomly divided into a training dataset and a validation dataset in a ratio of 8:2. The machine learning algorithms used in this study include Extreme Gradient Boosting (XGBoost), Support Vector Machines (SVM), Naive Bayes, Decision Trees (DT), and traditional Logistic Regression (LR). Feature selection, parameter optimization, and model construction were performed in the training set, while the validation set was used to evaluate the predictive performance of the models. The performance of these models is evaluated by an area under the receiver operating characteristic (ROC) curves (AUC), calibration curves and decision curve analysis (DCA). To interpret the best-performing model, the Shapley Additive exPlanation (SHAP) Plots was used in this study. The training/validation dataset consists of 1,855 individuals from the First Affiliated Hospital of Soochow University, yielded significant variables following selection by the Boruta algorithm and logistic multivariate regression analysis. These significant variables included systolic blood pressure (SBP), fatty liver, waist circumference (WC) and serum creatinine (Scr). The XGBoost model outperformed the other models, demonstrating an AUC of 0.7391 in the validation set. The XGBoost model was composed of SBP, fatty liver, WC and Scr may assist doctors with the early identification of IFG in middle-aged and elderly people.