BMI Index Research Articles

Acoustic pharyngometry - A new method to facilitate oral appliance therapy.

BackgroundThere is lack of reliable and accurate methods to predict treatment outcomes of oral appliance (OA) treatment. Acoustic pharyngometry (AP) is a non‐invasive technique to evaluate the volume and minimal cross‐sectional area of the upper airway, which may prove useful to locate the optimal position of OAs.ObjectiveThis retrospective study aimed to evaluate the effect of applying AP to OA treatment of patients with obstructive sleep apnoea (OSA).MethodsAll patients (n = 244) treated with OAs following an AP protocol at two dental clinics between 2013 and 2018 were invited to participate. A total of 129 patients accepted the invitation, and 120 patients (75 men, 45 women) were included in the analyses. Mean baseline age, BMI and apnoea hypopnea index (AHI) were 59.1 ± 0.9 years, 27.8 ± 0.4 and 21.9 ± 1.1, respectively. Mean follow‐up time was 318 ± 24 days.ResultsAHI at follow‐up was 6.4 ± 0.7, resulting in a treatment success rate of 86.7% (≥50% reduction of baseline AHI). The number of failures (<50% reduction of baseline AHI) did not differ significantly among patients with mild, moderate and severe OSA. 87.6% of the patients reported OA usage every night, and 95.5% reported > 5 hours usage per night, when worn.ConclusionThe AP protocol applied seems to contribute to the excellent effect of OA treatment in this study. Further research on the application of AP in OA treatment is necessary in order to clarify its possible beneficial contribution to improving OA therapy.

Outcomes of chronic distal biceps reconstruction with tendon grafting: a matched comparison with primary repair.

BackgroundThe purpose of this analysis was to analyze outcomes of distal biceps reconstruction with soft tissue allograft in the setting of chronic, irreparable distal biceps ruptures. The outcomes of these cases were then compared with a matched cohort of distal biceps ruptures that were able to be repaired primarily.MethodsRetrospective review of an institutional elbow surgery database was conducted. All cases of distal biceps repairs were identified by Common Procedural Terminology, ICD-9, and ICD-10 codes from January 2009 to March 2018. A direct review of operative reports was then conducted to identify which cases required allograft reconstruction. After identification of this population, a 2:1 manually matched cohort of patients who underwent primary repair was generated using age, gender, body mass index, and age-adjusted Charlson Comorbidity Index. Finally, the allograft reconstruction and matched primary repair cohorts were compared for reoperation, range of motion, and patient-reported outcomes scores.ResultsThere were 46 male patients who underwent distal biceps reconstruction with allograft (14 Achilles tendon, 32 semitendinosus) and they were matched to 92 male patients that underwent primary distal biceps repair. Mean patient age (46.9 ± 10.3 vs. 47.0 ± 9.8 years, P = .95), BMI (31.3 ± 5.3 vs. 31.3 ± 4.8 kg/m2, P = .60), and Charlson Comorbidity Index (1.2 ± 1.1 vs. 1.3 ± 0.9, P = .64) were similar between allograft reconstruction and primary repair groups. Disability of the Arm, Shoulder and Hand score (7.4 ± 18.0 vs. 1.6 ± 4.1, P = .23), Mayo Elbow Performance Score (92.1 ± 19.7 vs. 97.3 ± 6.4, P = .36), and Oxford Elbow Score (43.4 ± 11.0 vs. 46.8 ± 3.2, P = .25) were not significantly different between groups at mean 5.1 years (range, 1.5-10.9 years) after surgery. There were 1 of 42 (2.2%) allograft patients who require revision compared with 3 of 92 (3.3%, P = .719) in the primary repair group. In addition, one primary repair required reoperation for scar tissue excision and lateral antebrachial cutaneous neurolysis. Final range of motion data (twelve-week follow-up) for the allograft reconstruction group was similar to primary repair group in flexion (136.1° ± 5.3° vs. 135.9° ± 2.7°, P = .81), extension (0.8° ± 2.9° vs. 0.4° ± 1.7°, P = .53), pronation (78.0° ± 9.0° vs. 76.4° ± 15.4°, P = .50), supination (77.4° ± 10.7° vs. 77.5° ± 11.9°, P = .96).ConclusionPatients who underwent distal biceps reconstruction with a graft had similar failure rates, reoperation rates, final range of motion, and patient-reported outcomes scores as those treated without a graft. Patients can be consulted that direct repair in the acute setting is preferred; however, even in the setting of a distal biceps reconstruction with graft augmentation, they can expect low complications and good functional results.

Polysomnographic Sleep Parameters: Novel Digital Biomarkers for Developing Dementia

Neuroprotection, early diagnosis, and behavioral intervention are priorities for dementia research. Sleep is emerging as an important potential remediable risk factor. Polysomnography using various digital parameters, qualitatively and quantitively, evaluates sleep. In this study, we examined whether sleep parameters derived from attended overnight polysomnography (PSG) studies are associated with developing dementia. We retrieved 61,165 free-text PSG reports from the VA national electronic health records from 2000 to 2019. Patients with dementia diagnosis up to one-year after PSG were excluded. Patients who developed dementia >1 year after PSG (Dem) were classified using all-cause dementia ICD-9/10 codes documented on two separate visits starting a year after the PSG until the end of 2019 in a 1-year sliding period. Patients with no ICD-9/10 dementia codes (NDem) were propensity matched 1:1 for age, gender, race, ethnicity, BMI, and Charlston comorbidity index to the Dem group (n=1,534). We used natural language processing to identify sleep onset latency (SOL), total sleep time (TST), and apnea-hypopnea index (AHI). Univariate analysis was used to compare the groups. TST (254 v 266m, p=0.001) were significantly shorter and SOL (28 v 31m, p=0.047) were significantly prolonged in Dem compared to NDem. The odds ratio of individuals with an AHI ≥ 15 was significantly higher in Dem compared to NDem group (1.18, 95%CI: 1.04-1.35). Patients with incipient dementia exhibited longer SOL, shorter TST, and a greater proportion had moderate-to-severe apnea compared to patients without dementia. These objective sleep parameters may serve as potential biomarkers for patients at risk for developing dementia.

The Impact of Depression and Anxiety on Chronic Obstructive Pulmonary Disease Acute Exacerbations: A prospective cohort study

BackgroundTo explore the impact of anxiety and depression in chronic obstructive pulmonary disease(COPD) patients on the risk of acute exacerbation. Methods600 COPD patients were recruited and followed in Beijing, China. The demographic data, medical history, smoking history, therapy, assessments for anxiety and depression were completed by our physicians by face-to-face interview. Then the acute exacerbation events during the past one year was derived from their case record. Results504 people (295 men and 209 women) were thus included in the final analyses.The patients with anxiety scored more than 50 showed higher risk of acute exacerbation(54.1%) than those who scoring less than 50(39.8%). Similarly, the patients with depression scored more than 53 showed higher risk of acute exacerbation(52.1%) than those who scoring less than 53(40.4%). Eventually, Anxiety and/or depression will increase the risk of acute exacerbation in chronic obstructive pulmonary disease patients(AECOPD) (adjusted OR = 1.60, 95%CI: 1.10-2.31), after adjusting the influence of family history, duration of disease, BMI index and other factors. Besides, the prevalence of acute exacerbation in patients with anxiety and/or depression was higher than those without acute exacerbation (P<0.05). LimitationsThe frequency of AECOPD was limited to self-reported data, recall bias should be reconsidered, and it also may underestimate the association between anxiety and/or depression and AECOPD. Anxiety and depression were assessed by questionnaires rather than by a clinical diagnosis. ConclusionAnxiety and/or depression in stable COPD patients were significantly associated with a higher risk of acute exacerbation. Mental health care should be paid more attention, to decrease the risk of acute exacerbation in COPD patients.

Disproportionately low BNP levels in patients of acute heart failure with preserved vs. reduced ejection fraction

BackgroundB-type natriuretic peptide (BNP) has been widely used for the diagnosis of heart failure, its severity, and prognosis. However, little is known about factors related to disproportionately low BNP levels even during acute heart failure conditions. Methods and resultsAmong 424 patients hospitalized for acute heart failure, we categorized the patients into the HFpEF (LVEF > 50%) or HFrEF (LVEF ≤ 50%) group and subdivided them into disproportionately low BNP (LB) group and high BNP (HB) group using a cut-off BNP level of 200 pg/mL at admission. The proportion of patients with LB was higher in the HFpEF group (22.2%) than in the HFrEF group (10.9%, p = 0.002). Patients with LB had a high BMI, lower blood pressure, and history of previous cardiovascular surgery in the HFpEF group, while patients in the HFrEF group had a high BMI and smaller left ventricular end-diastolic volume index. Furthermore, presence of LB in the HFrEF group was related to good prognosis, but LB in the HFpEF group was an indicator of poor prognosis as HB group. ConclusionsThe factors associated with LB were different between the HFpEF and HFrEF groups. LB was related to good prognosis in HFrEF, but not in HFpEF.

Influence of maternal pre-pregnancy nutritional status on offspring anthropometric measurements and body composition in three Brazilian Birth Cohorts.

We aimed at evaluating the association of maternal pre-pregnancy nutritional status with offspring anthropometry and body composition. We also evaluated whether these associations were modified by gender, diet and physical activity and mediated by birth weight. Birth cohort study. Waist circumference was measured with an inextensible tape, and fat and lean mass were measured using dual-energy X-ray absorptiometry. Multiple linear regression was used to adjust for possible confounders and allele score of BMI. We carried out mediation analysis using G-formula. In 1982, 1993 and 2004, all maternity hospitals in Pelotas (South Brazil) were visited daily and all live births whose families lived in the urban area of the city were evaluated. These subjects have been followed up at different ages. Offspring of obese mothers had on average higher BMI, waist circumference and fat mass index than those of normal weight mothers, and these differences were higher among daughters. The magnitudes of the association were similar in the cohorts, except for height, where the association pattern was not clear. In the 1982 cohort, further adjustment for a BMI allele score had no material influence on the magnitude of the associations. Mediation analyses showed that birth weight captured part of this association. Our findings suggest that maternal pre-pregnancy nutritional status is positively associated with offspring BMI and adiposity in offspring. And this association is higher among daughters whose mother was overweight or obese and, birth weight explains part of this association.

The relationship between waist‐to‐hip ratio, BMI index and cognitive impairment in those aged 40 years or above: A cross‐sectional study in a rural area of Xi’an, China

AbstractBackgroundThe relationship between obesity, body weight and cognitive impairment is still controversial. To analyze the correlation between BMI index, waist‐to‐hip ratio and cognitive impairment.MethodThis study is a cross‐sectional survey conduct during October 2014 to March 2015. Subjects who aged 40 and above and lived in a village in the suburbs of Xi'an, China were selected as the research sample. Cognitive function was assessed using the Mini Mental State Scale (MMSE). Cognitive impairment was defined as a Mini‐Mental State Examination (MMSE) score lower than the cutoff value. Specifically, the cutoff value was ≤17 for the illiterate, ≤20 for the primary school educated, and ≤24 for those educated at the junior high school level or above. Height and weight were measured to calculate the BMI index; waist circumference and hip circumference were measured to calculate the waist‐hip ratio. Multivariate logistic regression was used to correct for confounding factors.ResultA total of 1792 subjects were enrolled in the study, including 726 males (40.5%), and were aged 40‐85 (average 55.53 ± 9.92) years. 230 subjects (12.8%) were diagnosed as having cognitive impairment. BMI index was 25.29 ± 3.14 kg/m2, and 433)24.2%( had BMI index &lt;23 kg/m2. WHR was 0.88 ± 0.06, and 462 subjects had WHR&gt; 0.92. Univariate analysis showed that those with a BMI index &lt;23 kg/m2 (&lt;23 vs 23‐25 vs 25‐27 vs ≥27 kg/m2, 16.2% vs 12.0% vs 12.1% vs 11.3%, P = 0.120), and those with WHR &gt;0.92 (&lt;0.84 vs 0.84‐0.88 vs 0.88‐0.92 vs ≥0.92, 12.1% vs 11.9% vs 11.0% vs 16.2%, P=0.082) tended to have higher risk for cognitive impairment. Multivariate logistic regression analysis showed that WHR ≥ 0.92 (OR = 1.619, 95% CI 1.161‐2.258, P = 0.005) and BMI &lt;23 kg/m2 (OR = 1.366, 95% CI 0.969‐1.927, P = 0.075) was ( or tend to) positive correlated with cognitive impairment.ConclusionIn the population aged 40 or above in rural areas of Xi'an, China, abdominal obesity and low body weight were positive correlated with cognitive impairment.

Faktor Determinan Pemanfaatan Posbindu

Background: Posbindu is part of the health service system covering promotive and preventive. Educational institution is dihambau to provide health facilities one of them Posbindu. Students are the most important part of educational institutions to support the need for healthy physical and psychological conditions. Posbindu can detect early risk of untransmitted diseases, including hypertension and obesity at the age of 18 years and above. Purpose of this study is to know the factors that affect the utilization of Posbindu. Methods: of research, a detailed analytical approach, the population of all active students in STIKES Mamba'ul ' Ulum Surakarta 258 people, sampling with purposive random sampling, a sample based on Solvin formula obtained from 94 respondents. Data retrieval using physical test result when in (BMI and blood pressure index) and questionnaire contains about the condition of the respondent's health and the utilization of in, each variable of ordinal and Inteval scale. Results: Respondents with a level of knowledge about Posbindu category quite 79%, BMI category ideal body weight 74%. Conslusion: Normal average blood pressure 65%, regular visit at Posbindu 2x visit. The results of a simple linear regression analysis test in the right factor on the utilization of Posbidu is knowledge, BMI and health status with a significance of 0.000 &lt; 0.05.

TRANSPORTING OBESE PERSONS USING AN EVACUATION PAD

Obesity is not only a medical illness but also a cosmetic problem. Obesity can be defined by the BMI index, which is not very accurate. The ABSI index, which includes BMI, the person’s waist circumference, and their height may be used to more accurately determine obesity. Time is very important in saving people's lives, especially in emergencies. The rescue time for obese people is even longer — often much longer — than for other disabled people. This is because more rescuers are needed, problems arise when they have to go through the door or go up and down stairs. For the evacuation of obese people, evacuation pads located under the mattress are often used. Evacuation pads are used, for example, by hospitals or social service homes. Evacuation pads are designed for use by nurses, other emergency staff, or caretakers. In this exercise, four people were used – two nurses and two firemen. To find out the advantages and disadvantages of the evacuation pad, we performed a tactical exercise.&#x0D; During the tactical exercise, the victim was evacuated by a single nurse, then by two nurses. After that, the victim was rescued by one firefighter and then two firefighters. This research is relevant to aspects of the rescue of immobile obese people with a special evacuation aid. It demonstrates the advantages and disadvantages of an evacuation pad based on actual tactical rescue exercises.

Daily intake of macronutrients and energy in childhood and its association with cardiometabolic risk factors in Colombians.

Determine the intake and percentage of adequacy of macronutrients and their association with cardiovascular risk factors in a sample of Colombian schoolchildren. Cross-sectional study nested in a prospective population-based cohort in schoolchildren between 6 and10 years of age; cardiovascular risk markers and anthropometric measures were measured. Macronutrient intake was established through a food consumption frequency questionnaire (FFQ). The percentage of adequacy was evaluated by comparison with the dietary reference intakes (DRI) and the recommendations for energy and nutrient intake (RIEN) for the Colombian population. Linear regression analysis was performed to assess the association between daily macronutrient/energy intake and cardiometabolic risk factors. A total of 1,282 school children (51.09% boys and 48.91% girls; mean age 8.4±1.4 years). The percentage of energy adequacy was 107% (Q1=87.5; Q3=127.2). The macronutrients in overadequacy were proteins and carbohydrates. The total fiber had a low adequacy around 26.0% (Q1=15.8; Q3=38.6). Fat intake was positively associated with BMI, insulin, and HOMA-IR index, while carbohydrate consumption was related to these same factors, although negatively in tight models. Schoolchildren in this study had an inadequate protein, carbohydrate, and fiber intake. The results suggest a significant positive and negative relationship between the consumption of both fat and carbohydrates and cardiometabolic risk factors such as BMI, insulin levels, and HOMA-IR.

The Hope Health and Wellness Clinic: Outcomes of Individuals with Serious Mental Illness in a Bidirectional Integrated Care Clinic.

The integrated health home, the Hope Health and Wellness Clinic, provides comprehensive primary and behavioral health services to adult clients of a Community Mental Health Center in Aurora, Colorado. A program evaluation of the effectiveness of this clinic was conducted over a 4year period. Physical health data (Body Mass Index BMI, HbA1c, cholesterol, blood pressure, and waist circumference measurements) and self-report data (social connectedness, everyday functioning, psychological distress, perceived health, satisfaction with services) were tracked across time. Individuals enrolled (N = 534) experienced significant improvements over time in LDL and total cholesterol, as well as self-reported social connectedness, everyday functioning, perceived health, and psychological distress. At risk individuals demonstrated significant improvements in HDL cholesterol, triglycerides, blood pressure, tobacco and alcohol use. Individuals with serious mental illness show improvements in physical health and self-reported health after being involved in bidirectional integrated care.

Occupational Exposure to Nickel in the Ceramic Workers: Biological Monitoring and Respiratory Outcomes

Background: Nickel (Ni) compounds such as nickel oxide are used as pigments in ceramic industries. The toxicity of nickel can occur in the glaze preparation processes. This study aimed to ascertain whether exposure to Ni dust is associated with pulmonary response. Methods: This cross-sectional study was performed on 49 ceramic workers (exposed group) occupationally exposed to nickel dust, as well as 55 unexposed employees (referent group). Information about smoking habits, overtime work, length of employment, skin dermatitis, job title, use of respiratory protection equipment, ventilation system, age, and BMI index were collected through questionnaires. The parameters of pulmonary function were measured. Urine samples were taken from 49 workers at both pre- and post-shift (98 samples). The referent group was examined only once (55 samples). To determine the nickel, the samples were pre-concentrated by Solid Phase Extraction (SPE) and analyzed using inductively coupled plasma-atomic emission spectroscopy (ICP-AES). Results: Urinary Ni value in the exposed workers was significantly higher than that in the referent group. All pulmonary function parameters in the exposed group were significantly lower than those of the referent group (P&lt;0.001). Those using respiratory protection equipment also exhibited a significantly lower urinary Ni concentration than those not using respiratory protection equipment. Conclusion: These findings indicate that exposure to Ni in the ceramic industry is higher than the recommended biological exposure index and is associated with a significant decrement in the pulmonary function parameters.

Fluorescent cholangiography significantly improves patient outcomes for laparoscopic cholecystectomy

Laparoscopic cholecystectomy (LC) is the most common elective abdominal surgery in the USA, with over 750,000 performed annually. Fluorescent cholangiography (FC) using indocyanine green dye (ICG) permits identification of extrahepatic biliary structures to facilitate dissection without requiring cystic duct cannulation. Achieving the "critical view of safety" with assistance of ICG cholangiogram may support identification of anatomy, safely reduce conversion to open procedures, and decrease operative time. We assess the utility of FC with respect to anatomic visualization during LC and its effects on patient outcomes. A retrospective review of a prospectively maintained database identified patients undergoing laparoscopic cholecystectomy at a single academic center from 2013 to 2019. Exclusion criteria were primary open and single incision cholecystectomy. Patient factors included age, sex, BMI, and Charlson Comorbidity Index. Outcomes included operative time, conversion to open procedure, length of stay (LOS), mortality rate, and 30-day complications. A multivariable logistic regression was performed to determine independent predictors for open conversion. A total of 1389 patients underwent laparoscopic cholecystectomy. 69.8% were female; mean age 48.6years (range 15-94), average BMI 29.4kg/m2 (13.3-55.6). 989 patients (71.2%) underwent LC without fluorescence and 400 (28.8%) underwent FC with ICG. 30-day mortality detected 2 cases in the non-ICG group and zero with ICG. ICG reduced operative time by 26.47min per case (p < 0.0001). For patients with BMI ≥ 30kg/m2, operative duration for ICG vs non-ICG groups was 75.57 vs 104.9min respectively (p < 0.0001). ICG required conversion to open at a rate of 1.5%, while non-ICG converted at a rate of 8.5% (p < 0.0001). Conversion rate remained significant with multivariable analysis (OR 0.212, p = 0.001). A total of 19 cases were aborted (1.35%), 8 in the ICG group (1.96%) and 11 in the non-ICG group (1.10%), these cases were not included in LC totals. Average LOS was 0.69 vs 1.54days in the ICG compared to non-ICG LCs (p < 0.0001), respectively. Injuries were more common in the non-ICG group, with 9 patients sustaining Strasberg class A injuries in the non-ICG group and 2 in the ICG group. 1 CBDI occurred in the non-ICG group. There was no significant difference in 30-day complication rates between groups. ICG cholangiography is a non-invasive adjunct to laparoscopic cholecystectomy, leading to improved patient outcomes with respect to operative times, decreased conversion to open procedures, and shorter length of hospitalization. Fluorescence cholangiography improves visualization of biliary anatomy, thereby decreasing rate of CBDI, Strasberg A injuries, and mortality. These findings support ICG as standard of care during laparoscopic cholecystectomy.

Leptin levels predict the development of left ventricular hypertrophy in a sample of adult men: the Olivetti Heart Study.

A higher leptin (LPT) is associated with a greater cardiometabolic risk. Some studies also showed a positive association between LPT and cardiovascular organ damage but no consistent data are available about a predictive role of LPT on cardiac remodelling. Hence, the aim of this study was to evaluate the potential role of LPT on the incidence of left ventricular hypertrophy (LVH) in a sample of adult men. The study population was made up of 439 individuals (age: 51 years) without LVH at baseline, participating in The Olivetti Heart Study. The ECG criteria were adopted to exclude LVH at baseline and echocardiogram criteria for diagnosis of LVH at follow-up were considered. At baseline, LPT was significantly and positively correlated with BMI, waist circumference, ECG indices, SBP and DBP but not with age and renal function. At the end of the 8-year follow-up period, there was an incidence of 23% in LVH by echocardiography. Individuals who developed LVH had higher baseline age, LPT, BMI, waist circumference, blood pressure and ECG indices (P < 0.05). Furthermore, those that had LPT above the median had greater risk to develop LVH (odds ratio: 1.7; P < 0.05). This association was also confirmed after adjustment for main confounders, among which changes in blood pressure and anthropometric indices. The results of this study suggest a predictive role of circulating LPT levels on cardiac remodelling expressed by echocardiographic LVH, independently of body weight and blood pressure changes over the years.

Analysis of Body Mass Index (Bmi) In Relation to Cancer in Rural Population of Faridkot, Malwa Region, Punjab

Analysis of Body Mass Index (Bmi) In Relation to Cancer in Rural Population of Faridkot, Malwa Region, Punjab

S0542 Intraoperative Morbidity Associated With Monitored Anesthesia Care in Obese Patients Undergoing Average Risk Colorectal Cancer Screening

INTRODUCTION: Average risk Colorectal Cancer (CRC) screening colonoscopy requires procedural sedation and monitored anesthesia care (MAC). Elevated BMI is associated with higher prevalence of comorbid conditions including obstructive sleep apnea, hypertension, and pulmonary hypertension. Pre-existing comorbidities, including obesity, may be associated with increased intraoperative cardiopulmonary (ICP) morbidity related to procedural sedation. The aim of our quality improvement project was to evaluate intraoperative morbidity associated with MAC during screening colonoscopy in obese patients. METHODS: Data were collected by retrospective chart review of 304 randomly selected patients undergoing average risk CRC screening colonoscopy at Allegheny Health Network. Demographic data for obese (n = 152) and non-obese (n = 152) cohorts were collected (Table 1). BMI and intraoperative indices including arrhythmia, hypotension, and oxygen saturation, were extracted and analyzed using Pearson’s Chi-Squared Test. Independent T-Test was performed to compare average oxygen desaturation time (ODT). RESULTS: 77.3% of patients were BMI 25–29.9 (27.3%), 30–40 (25.3%) and ≥40 (24.7%) (Table 1). 52.6% of obese patients experienced oxygen desaturation (SaO2 < 95%) as compared to 46.7% in non-obese patients, but this was not statistically significant. Obese patients did have lower mean initial SaO2 and statistically significant increased time with SaO2 < 95% (P = .007). There was no statistically significant association between obesity and intraoperative complications including hypotension, arrhythmia, and hypoxia. CONCLUSION: Our study shows no statistically significant difference in ICP morbidity related to obesity(BMI >30), except for ODT. These findings suggest that patients with obesity are at higher risk of prolonged oxygen desaturation during MAC assisted colonoscopies. Further larger studies are needed to evaluate the clinical implications of prolonged ODT in obese patients.Table 1.: Patient demographics and comorbiditiesTable 2.: Rates of intraoperative cardiopulmonary complications in obese and non-obese patients while under MAC during screening colonoscopyTable 3.: A and 3B. 3A: T-test for Equality of Means showing statistically significant increased ODT minutes in obese patients; 3B: Obese vs. Non-Obese Group Statistics for intraprocedural oxygenation status

S0582 Prevalence of GI Symptoms in COVID-19 Patients and Their Impact on Clinical Outcomes, from the Epicenter of COVID-19: Multicenter Study of Academic Centers in Brooklyn

INTRODUCTION: SARS-CoV-2 has infected more than 2.12 million people in United States. GI symptoms have frequently been reported in association with COVID-19. Studies have reported prevalence and impact of GI symptoms on COVID-19 outcomes with marked variability in different regions of the world. We investigated the association of GI symptoms with clinical characteristics and mortality in COVID-19 in a diverse multiethnic population in Brooklyn, NY. METHODS: We performed a retrospective study of patients who were positive for SARS-CoV2 and were admitted from 04/01/20 through 04/15/20 at four academic medical centers in Brooklyn. We collected data on COVID-19 symptoms, medical comorbidities, clinical outcomes and GI symptoms at presentation including nausea, vomiting, diarrhea, abdominal pain, anorexia, and GI bleeding (Table 1). We compared length of hospital stay, ICU admission rate, and all-cause mortality in patients with GI symptoms at presentation (Group A) with patients who did not have any GI symptoms (Group B). Charlson Comorbidity Index (CCI) was used to account for comorbid conditions and CURB65 score for pneumonia severity. Groups were compared with Wilcoxon Rank Sum, Chi-Square and Fisher’s exact test. Logistic regression was used to evaluate the association of GI symptom at presentation with all-cause mortality. RESULTS: Of the total of 680 patients included, 48.9% were black, average age was 66.8 years, no significant difference in gender distribution, and mean BMI for the cohort was 30.27 kg/m2Table 1). 36.02% of patients had at least one GI symptom at presentation. Most common presenting GI symptom was anorexia (19.7%) followed by diarrhea (13%) and nausea (7.2%). Baseline mean CCI score for group A and B were 3.50 and 3.85 respectively (P = 0.11). CURB65 score at presentation was lower in Group A (mean 1.61) compared to Group B (mean 1.83) (P = 0.028). There was no significant difference in ICU care requirements between the groups (17.6% (A) vs. 21.8% (B), P = 0.18). Group A had slightly longer mean length of hospital stay 8.85 vs. 8.30 days (group B), (P = 0.07). When adjusted for age, BMI, ethnicity, sex and pneumonia severity index, presence of a GI symptom at presentation was not associated with mortality (OR 0.8; 95% CI: 0.55, 1.16; P = 0.24. CONCLUSION: In hospitalized COVID-19 patients, presence of GI symptoms at presentation was not associated with higher mortality. Patients without a GI symptom presented with higher pneumonia severity.Table 1.: Demographic and baseline characteristics of the patientsTable 2.: GI symptom prevalence at presentationFigure 1.: GI specific symptoms at presentation.

Adalimumab and methotrexate affect the concentrations of regulatory cytokines (interleukin-10, transforming growth factor-β1, and interleukin-35) in patients with plaque psoriasis.

Dysfunctional regulatory T lymphocytes are important for the pathogenesis of psoriasis and atherosclerosis. We analyzed the severity of atherosclerosis and the concentration of regulatory cytokines in patients with psoriasis who were administered methotrexate or adalimumab for 12 weeks. We included 34 patients with psoriasis (17 each, administered methotrexate or adalimumab) and eight healthy volunteers. BMI, psoriasis area and severity index (PASI), body surface area (BSA), and at least 75% and 90% improvements in PASI were observed. The 10-year risk of fatal cardiovascular disease was estimated using Systematic Coronary Risk Evaluation charts. The plasma interleukin (IL)-10, IL-35, and transforming growth factor β1 (TGF-β1) levels were determined using enzyme-linked immunosorbent assay before and after the 12-week treatment regimen. PASI (P = .0006) and BSA (P = .0001) were positively correlated with the BMI, IL-35 (-0.38), and IL-10 (0.48) levels. Baseline IL-35 concentrations were the highest in healthy volunteers; the IL-10 and TGF-β1 level were the highest in the methotrexate group. IL-10 concentration decreased in both treatment groups (P = .02 for the methotrexate and P = .09 for adalimumab group), and IL-35 decreased in the adalimumab group (P = .019), consistent with skin lesion recovery. Thus, this study demonstrates the dysregulated secretion of regulatory cytokines in psoriatic patients under systemic treatment.

Özel Bir Hastanede Yatan Yetişkin Kanser Hastarında Malnutrisyon Prevalansı ve Tarama Ölçekleri İle Antropometrik Ölçümlerın Tutarlılığı: Kesitsel Çalışma

Objectives: Malnutrition is a common complication seen among cancer patients and may affect morbidity and mortality. Thus, evaluation of nutritional status and screening for malnutrition is crucial both for prevention and intervention. In this crosssectional study, we aimed to evaluate malnutrition prevalence and compare two malnutrition screening tools and anthropometric measures among adult cancer patients.Material and Method: The study was conducted in a private hospital with 59 patients between 7th of January and 7th of April in 2016. Nutritional screening and assessment tools and measurements were applied 48 hours after the patient was admitted to the hospital. We used two tools for detecting malnutrition which are Nutritional Risk Screening-2002 NRS-2002 and Subjective Global Assessment SGA . Anthropometric measurements were body mass index BMI , triceps skinfold thickness TST , and midupper arm circumference MUAC .Results: According to NRS-2002 results, 41% of the patients were under nutritional risk and SGA results were consistent regarding malnutrition screening p

Obesity Measures and Dietary Parameters as Predictors of Gut Microbiota Phyla in Healthy Individuals.

The dynamics and diversity of human gut microbiota that can remarkably influence the wellbeing and health of the host are constantly changing through the host’s lifetime in response to various factors. The aim of the present study was to determine a set of parameters that could have a major impact on classifying subjects into a single cluster regarding gut bacteria composition. Therefore, a set of demographical, environmental, and clinical data of healthy adults aged 25–50 years (117 female and 83 men) was collected. Fecal microbiota composition was characterized using Illumina MiSeq 16S rRNA gene amplicon sequencing. Hierarchical clustering was performed to analyze the microbiota data set, and a supervised machine learning model (SVM; Support Vector Machines) was applied for classification. Seventy variables from collected data were included in machine learning analysis. The agglomerative clustering algorithm suggested the presence of four distinct community types of most abundant bacterial phyla. Each cluster harbored a statistically significant different proportion of bacterial phyla. Regarding prediction, the most important features classifying subjects into clusters were measures of obesity (waist to hip ratio, BMI, and visceral fat index), total body water, blood pressure, energy intake, total fat, olive oil intake, total fiber intake, and water intake. In conclusion, the SVM model was shown as a valuable tool to classify healthy individuals based on their gut microbiota composition.