SD Body Mass Index Research Articles

THU033 High Prevalence Of Venous Thrombotic Events In Cushing’s Syndrome: Data From ERCUSYN

Abstract Disclosure: K. Isand: None. R.A. Feelders: None. T.C. Brue: None. M. Toth: None. T. Deutschbein: None. M. Reincke: None. M. Krsek: None. A. Santos: None. F. Demtroder: None. O. Chabre: None. C.J. Strasburger: None. J.A. Wass: None. S.M. Webb: None. A. Aulinas Maso: None. V. Volke: None. E. Valassi: None. For all ERCUSYN investigators Background: Patients with Cushing’s syndrome (CS) have increased risk of developing venous thromboembolic complications. The UK audit and meta-analysis of literature on Cushing’s disease (CD) over 50-years in Stoke-on-Trent by Clayton et al concluded that overall mortality in CD is double that of the general population. The risk of a thrombotic event (TE) (both arterial and venous) in patients with CS has been reported to be up to 10 times higher than that of the general population. When it comes to the cause of death, atherosclerotic diseases and venous thromboembolism (VTE) account for 43.4% of the deaths in patients with endogenous CS. Aim: To evaluate the prevalence of VTE in patients included in The European Registry on Cushing’s syndrome (ERCUSYN) and to study the details of each event to determine if there is any common line in patients who have been diagnosed with VTE. Methods: A retrospective observational cohort study; data extraction from the registry was taken on the 07.02.2022. Results: There were 95 VTE events among 2173 CS patients (prevalence of 4.4 %). Among the 57 centres included in the database (from 26 European countries), events were reported in 28 (from 16 countries). Patients were aged between 14-75 years, median age 47 years; 63(66%) were female. The 95 VTE events were observed in 70 (74%) pituitary-dependent, 12 (13%) adrenal-dependent, 10 (11%) ectopic and 3(3%) CS due to other causes. Comparing aetiologies, ectopic origin accounted for 10.5% of VTE patients and only 5% of those without VTE. Mean ± SD body mass index (BMI) reported in 68/95 patients was 28.8 ± 10.7 kg/m2, and more than three quarters (52; 76%) had a BMI above 25 kg/m2, being either overweight or obese; 21 (22%) patients were smoking. The most frequent comorbidity was hypertension (65 cases, 68%), followed by diabetes mellitus (40 cases, 42%) and osteoporosis (23, 24%); 7 (7%) had a cancer; 7 (7%) had active hypercortisolism (defined by elevated levels of midnight serum cortisol, urinary cortisol or cortisol day curve), 15 (16%) were in partial remission, 46 (48%) were cured and for 7 (7%) the status was unknown. Sixty-two (65%) had had 1 surgery, 22 (23%) had had two surgeries and 1 in the VTE group had 5 operations. Comparing groups, the VTE group had more surgeries than the no-VTE group. Mean operation rate per patient was 1.42 for the VTE group and 1.2 for no-VTE event group (p=0.0068). Seven (7%) patients died during the follow-up time (for different reasons). Conclusion: We report a high VTE rate in CS patients within ERCUSYN. Of note, to our knowledge this is the largest registry-based study to date looking at VTE in CS patients. Importantly, more than half of the VTE events were diagnosed in patients with normocortisolaemia. Presentation: Thursday, June 15, 2023

Dietary advanced glycation end products are associated with an increased risk of breast cancer in Iranian adults

BackgroundDietary advanced glycation end products (AGEs) can play an important role in increasing inflammatory factors and oxidative stress as risk factors for cancers. In the present study, we aimed to assess the relationship between dietary AGEs and the risk of breast cancer (BC) in Iranian adult women.MethodsThis hospital-based case-control study includes 401 participants aged ≥ 30 years old. The cases group consisted of 134 women diagnosed with histologically confirmed BC. The control group included 267 women enrolled randomly from patients admitted to the same hospitals. Dietary intake information was determined using a validated food frequency questionnaire, and dietary AGEs intake was computed for all participants. Logistic regression models, adjusted for potential confounders, were used to determine the odds ratios (OR) and 95% confidence interval (CI) of BC across tertiles of dietary AGEs.ResultsThe mean ± SD age and body mass index of the study population were 47.92 ± 10.33 years and 29.43 ± 5.51 kg/m2, respectively. The median (interquartile) of dietary AGEs in all individuals was 9251(7450, 11,818) kU/day. After adjusting for age, first pregnancy age, and energy intake, participants in the highest tertile of dietary AGEs intakes had higher odds of BC compared to those in the lowest tertile of dietary AGEs (OR:2.29;95%CI:1.19–4.39, Ptrend:0.012). Additionally, in the multivariable model, after adjusting for age, age at first pregnancy, energy, menopausal status, family history of cancer, anti-inflammatory drug use, Vitamin D supplementation, physical activity, body mass index, number of childbirths, and history of abortion, breastfeeding, and oral contraceptive pills use, the odds of BC were increased across tertiles of dietary AGEs intake (OR: 2.33; 95%CI: 1.18–4.60, Ptrend: 0.017).ConclusionThe present findings suggest that a diet with high AGEs is associated with a higher likelihood of BC in adult women.

The Effect of SARS-Cov2 Infection on The Spermogram: A Prospective Study.

During the Coronavirus disease 2019 (COVID-19) pandemic, there was always concern about damage to different organs of the body. In this study, we aimed to determine if coronavirus 2 (SARS-CoV-2) could influence the sperm parameters in inpatient adult men with COVID-19. In this prospective study during 2021, 22 patients with COVID-19 diagnosed with polymerase chain reaction (PCR) test and clinical symptoms and history of admission and 19 volunteer healthy men as the control group participated. They were asked to provide semen samples at 2 and 6 months after hospital discharge and the same time for the control group. The following parameters were measured in all semen samples and beside the demographic data, they compared between the two groups: volume (mL), sperm concentration (106/mL), total motile sperm percentage, progressive percentage, normal morphology percentage, and DNA fragmentation index (DFI). The mean ± SD age of the participants in the COVID and control groups was 46.36 ± 9.94 and 45.84 ± 10.21 years, respectively (P=0.869). The mean ± SD body mass index (BMIs) of the participants in the COVID and control groups were 28.6 ± 5.460 and 29.6 ± 6.092, respectively (P=0.579). The mean ± SD number of children was 1.41 ± 1.054 in the COVID group and 1.47 ± 1.073 in the control group (P=0.847). All the sperm parameters were significantly impaired after 2 months in the COVID group in comparison with the control group (P<0.05). After 4 months from first sampling, all the parameters were improved significantly (except normal morphology) but had not yet reached the level of the control group. SARS-CoV-2 affected semen parameters in patients admitted because of COVID-19, in the short term. It is expected that this will improve with time.

Effect of Home-based Aerobic Exercise on Leukocyte TERT Gene Expression Without Altering DNA Oxidative Damage in Postmenopausal Women

Objectives: In middle-aged women, the postmenopausal period is associated with increased oxidative, inflammatory, and psychological stress. We intend to investigate the effect of home-based aerobic exercise (HAE) on serum levels of 8-hydroxy-2’-deoxyguanosine (8-C) and the expression of telomerase reverse transcriptase (TERT) in leukocytes of postmenopausal women. Methods: A total of 20 sedentary postmenopausal women who had at least 12 months passed since their last menstruation participated in the study voluntarily. Their Mean±SD age, height, weight, and body mass index (BMI) were respectively 52.4±3.8 years, 161.4±3.7 cm, 74.4±6.8 kg, and 28.6±3.4 kg/m2 . They were randomly divided into two groups: Home-based aerobic exercise (HAE, n=10) and inactive control (CON, n=10). HAE group undertook 4 weeks of home-based aerobic exercise (4 d/wk, intensity: 70%-80% maximal heart rate) with online supervision. Participants’ weight and fasting blood samples (12-h fasting state) were measured and taken before and 48 hours after the intervention. TERT expression in blood leukocytes and serum levels of 8-OHDG were assessed by real-time PCR and ELISA methods, respectively. The collected data were analyzed using mixed (2×2) repeated measure ANOVA and independent samples t-test in SPSS software. A significance level of P&lt;0.05 was considered for all tests. Results: The findings showed that 4 weeks of HAE increased TERT expression significantly compared to the CON (ES=0.40, P&lt;0.05). Although 8-OHDG serum level in the HAE group increased following training compared to pre-training (P&lt;0.05), no significant difference was observed between the CON and HAE groups (P&gt;0.05). Also, the interaction effect on 8-OHDG was not significant (ES=0.11, P&gt;0.05). In addition, after 4 weeks of HAE, body weight and BMI significantly decreased in the training group compared to the control (P&lt;0.05). Discussion: According to these findings, HEA effectively reduces telomere erosion and improves weight control in postmenopausal women.

Cross-sectional assessment of body composition and detection of malnutrition risk in participants with low body mass index and eating disorders using 3D optical surface scans

BackgroundNew recommendations for the assessment of malnutrition and sarcopenia include body composition, specifically reduced muscle mass. Three-dimensional optical imaging (3DO) is a validated, accessible, and affordable alternative to dual X-ray absorptiometry (DXA). ObjectiveIdentify strengths and weaknesses of 3DO for identification of malnutrition in participants with low body mass index (BMI) and eating disorders. DesignParticipants were enrolled in the cross-sectional Shape Up! Adults and Kids studies of body shape, metabolic risk, and functional assessment and had BMI of <20 kg/m2 in adults or <85% of median BMI (mBMI) in children and adolescents. A subset was referred for eating disorders evaluation. Anthropometrics, scans, strength testing, and questionnaires were completed in clinical research centers. Lin’s Concordance Correlation Coefficient (CCC) assessed agreement between 3DO and DXA; multivariate linear regression analysis examined associations between weight history and body composition. ResultsAmong 95 participants, mean ± SD BMI was 18.3 ± 1.4 kg/m2 in adult women (N = 56), 19.0 ± 0.6 in men (N = 14), and 84.2% ± 4.1% mBMI in children (N = 25). Concordance was excellent for fat-free mass (FFM, CCC = 0.97) and strong for appendicular lean mass (ALM, CCC = 0.86) and fat mass (FM, CCC = 0.87). By DXA, 80% of adults met the low FFM index criterion for malnutrition, and 44% met low ALM for sarcopenia; 52% of children and adolescents were <−2 z-score for FM. 3DO identified 95% of these cases. In the subset, greater weight loss predicted lower FFM, FM, and ALM by both methods; a greater percentage of weight regained predicted a higher percentage of body fat. Conclusions3DO can accurately estimate body composition in participants with low BMI and identify criteria for malnutrition and sarcopenia. In a subset, 3DO detected changes in body composition expected with weight loss and regain secondary to eating disorders. These findings support the utility of 3DO for body composition assessment in patients with low BMI, including those with eating disorders.This trial was registered at clinicaltrials.gov as NCT03637855.

Evaluation of Bone Mineral Density in Children with Celiac Disease

Background: Osteoporosis is a known entity in individuals with celiac disease (CD). Objectives: The aim of this study was to evaluate bone mineral density (BMD) measurements in children with CD. Methods: This was a retrospective design study in a tertiary hospital in Turkey. Results: Totally 106 patients were included, and the mean age was 10.2 ± 3.9 years. The mean L1-L4 Z score was 0.730 ± 0.197 (based on sex and height in Turkish children). About 20.7% (n = 22) had a history of at least one fracture and/or bone pain. Bone mineral density values obtained from lumbar (L1-L4) vertebrae were significantly lower in patients with a prior fracture and/or bone pain compared to the patient group without a fracture (0.822 ± 0.242 g/cm2 vs 0.706 ± 0.178 g/cm2, respectively; P = 0.047). L1-L4 Z score (based on sex and height in Turkish children) was lower in patients with a body mass index (BMI) SDS value below -2 (moderately or severely malnourished) than those with a BMI SDS above -2 (0.02 ± 1.19 vs 1.4 ± 1.82, respectively; P = 0.014). A moderate positive correlation (r = 0.547; P &lt; 0.01) was found between somatomedin-C (IGF-1) level and L1-L4 BMD (g/cm2) measurement. It was remarkable that low BMD was not identified in any patients using L1-L4 Z-score by height and L1-L4 Z-score by age of Turkish children. Nine (8.5%) patients were found to have low BMD using the United States (US) age- and sex-specific L1-L4 Z-score from the GE Healthcare Lunar iDXA system. Conclusions: Bone mineral density should be screened considering risk factors for suboptimal bone health in children with celiac disease. False "normal" BMD interpretations can be avoided by taking into account the model of the BMD measuring device and by using the device's normal ranges in case of inconsistency with the Turkish reference values.

Precocious Puberty Diagnoses Spike, COVID-19 Pandemic, and Body Mass Index: Findings From a 4-year Study.

Since the COVID-19 outbreak, the number of girls with suspected precocious puberty has increased. To compare the incidence of idiopathic central precocious puberty (ICPP) during COVID-19 with that of the previous 4 years. Anthropometric, biochemical, and radiological parameters were collected between January 2016 and June 2021 from 133 girls who met the Rapidly Progressive ICPP criteria (RP-ICPP). We found a higher incidence of RP-ICPP between March 2020 and June 2021 (group 2) compared with January 2016 through March 2020 (group 1) (53.5% vs 41.1%); 2021 showed the highest annual incidence (P < .05). Group 1 and group 2 differed in age at diagnosis (7.96 ± 0.71 vs 7.61 ± 0.94; P < .05), mean Tanner stage (2.86 ± 0.51 vs 2.64 ± 0; P < .05), and in the time between the appearance of thelarche and diagnosis (0.93 ± 0.75 vs 0.71 ± 0.62 years, P < .05). There was an increase in the number of girls aged <8 years in group 2 and a significantly higher number of girls aged >8 years was found in group 1 (42 in group 1 vs 20 in group 2, P < 0.05). Overall body mass index SD score showed higher values ​​in group 2 (1.01 ± 1.23 vs 0.69 ± 1.15; P = .18), which spent an average of 1.94 ± 1.81 hours per day using electronic devices; 88.5% of this group stopped any physical activity. A spike in new diagnoses of idiopathic (1.79-fold higher) and RP-CPP coincided with the COVID-19 pandemic. The incidence of RP-ICPP was 1.3-fold higher during COVID-19 with a trend toward an increase in body mass index SD score. The expanding use of digital devices and the reduction of daily physical activity represent possible risk factors.

Childhood Grave’s-an experience from a tertiary care center

Background: Graves’ disease (GD) attributes for important cause for childhood hyperthyroidism with a prevalence of 0.02%. Initial treatment for GD is the use of antithyroid drugs (ATDs), which is well accepted. The remission rate is around about 30% of children treated with ATD. Aims and Objective: (1) To assess the predictors of relapse and remission after ATD in children with Grave’s disease. (2) To study the clinical profile at presentation and treatment outcome of children with Grave’s disease. Materials and Methods: We conducted a prospective cohort study of children diagnosed for GD (n=27) and treated with either carbimazole (0.6–0.8 mg/kg), methimazole (0.2–1 mg/kg), or (propylthiouracil, 5–10 mg/kg) and continued till euthyroid state was achieved. The dose was titrated every 2 months once till the achievement of the euthyroid state. Assessment of remission and relapse was done within a year of stopping the drug. Results: The overall estimated relapse rate for hyperthyroidism was 54.1% (13 patients), within a year of stopping ATD with a mean duration treatment of 24.23±7.44 months. Multivariate survival analysis showed that the risk of relapse (87.5%) was higher for patients of a body mass index SD score &lt;0.5 and a large goiter. Pre-pubertal patients had higher relapse rate than pubertal patients (OR- 3.24, P=0.04). No other clinical variables such as age, gender, and Wayne Index were significantly associated with relapse, though patients in the relapse group were younger, and had a male predominance with higher Wayne index scores. Conclusion: GD in children has a high relapse rate. Severity of the disease as measured by various clinical methods is important in predicting relapse.

Use of Transparent Film Dressing to Facilitate Mask Ventilation in Bearded Patients

BackgroundMask ventilation is a critical airway procedure made more difficult in the bearded patient. ObjectiveWe sought to objectively investigate whether application of transparent cling film (TegadermTM; 3M Healthcare, Maplewood, MN) over a beard in the operating room improves the quality of mask ventilation. MethodsThis was a randomized crossover trial of bearded adult patients undergoing surgery. Exclusions included emergency procedures, American Society of Anesthesiologists physical status classification > 3, a documented history of difficult mask ventilation, and body mass index (BMI) > 50. Transparent cling film was applied snuggly over the lower face with a 2- to 3-cm slit cut over the mouth after anesthesia induction. Mask ventilation performed by an anesthesiology resident, anesthesiology assistant, or anesthesiology assistant student and standardized to a thenar-eminence grip without use of airway adjuncts in a sniffing position. Standardized pressure-controlled ventilations were delivered via an anesthesia machine. A calibrated external pneumotachograph was used to measure delivered and returned tidal volumes from which raw and percent air leak were calculated. A clinically significant difference was determined a priori to be 15%, necessitating the enrollment of 25 patients. ResultsOf 25 subjects, 96% were men with a mean ± SD BMI of 29.3 ± 6. Seventeen (68%) had a full beard and 8 (32%) had a partial beard. The mean ± SD leakage was 48% ± 26% for transparent cling film vs. 46% ± 20% without its application, which was not significantly different (p = 0.67). ConclusionsThe use of transparent cling film to cover the lower half of the bearded face did not have an impact on the ability or efficacy to perform mask ventilation in the operating room setting. ClinicalTrials.gov, Number NCT04274686.

Elevated IGF-1 concentrations in children with low grade glioma: A descriptive analysis in a retrospective national cohort.

Children with low grade glioma (LGG) may present with, or develop, elevated concentrations of insulin-like growth factor 1 (IGF-1). The prevalence, pathophysiology, or its possible clinical effects are poorly understood. Our aim was to evaluate the prevalence of such elevated IGF-1 concentrations and to describe its association with linear growth, body mass index (BMI), pituitary outcome, and tumor behavior in a large retrospective national cohort. From a nationwide retrospective cohort of pediatric brain tumor survivors diagnosed between 2002 and 2012, tumor, treatment, endocrine, and auxological data of children with LGG were collected (n = 358). Prevalence and risk factors for elevated IGF-1 concentrations, as well as the association between having elevated IGF-1 concentrations and receiving tumor treatment, were explored. IGF-1 concentrations had only been measured in 45.5% of cases (n = 163/358). In 18.4% of 163 children with available IGF-1 measurements, IGF-1 concentrations were found elevated. No association was described between having an elevated IGF-1 concentration and tumor behavior or height SDS at last moment of follow-up. Multivariate logistic regression identified posterior pituitary disorder (OR 6.14 95% CI: 2.21-17.09) and BMI SDS at follow-up (OR 1.56 95% CI: 1.09-2.20) to be significantly associated with elevated IGF-1 concentrations. In this retrospective cohort of children with LGG, IGF-1 was found elevated in 18.4% of children with available IGF-1 measurements. Elevated IGF-1 seems to be related to hypothalamic dysfunction worsening over time. Larger prospective cohort studies are needed.

Assessment of major liver enzymes activities among sickle cell subjects in Enugu South East of Nigeria

Objective: Sickle cell anemia is a condition resulting from inheritance of two abnormal allele of genes controlling β-globin formation. This haemoglobinopathy affects multiple organ system in the body. The hepatobiliary system is most commonly affected in sickle cell disease. This study assessed liver enzymes activities in sickle cell subjects in Enugu, Nigeria. Methods: We recruited about hundred subjects age (20-40years) for this study. Fifty sickle cell subjects (Male =22, Female=28) as test subjects and fifty non-sickle cell subjects (Male=24, Female=26) as control. Anthropometric indices were measured and five milliliters of blood sample collected from each participant for analysis of Alanine transaminase (ALT), alkaline phosphatase (ALP), and Aspartate transaminase (AST) using autoanalyser. Data were analysed using statistical package for the social sciences (SPSS) version 25. Results: The sickle cell subjects showed a significant decrease (P&lt;0.05) in mean ± SD of systolic BP, diastolic BP and body mass index compared to control subjects. The liver enzymes analysis showed a statistical increase (P&lt;0.05) in ALP and AST while a non-significant increase (P&gt;0.05) exist in ALT of sickle cell subjects compared to non- sickle cell subjects. There is a positive correlation (P&lt;0.05) in SBP vs. DBP, ALT vs. AST, ALT vs. BMI among the test subjects. Conclusion: This study suggests that there is increase in liver enzymes activities in sickle cell subjects compared to non- sickle cell subjects, which could lead to liver complications and hence, need for regular assessment.

Treatment and outcome of the Dutch Childhood Craniopharyngioma Cohort study: First results after centralization of care.

Childhood craniopharyngioma (cCP) has excellent survival, but quality of life may be severely hampered by hypothalamic dysfunction. We aimed to evaluate treatment and hypothalamic outcomes of a Dutch cCP cohort, and evaluate the effect of centralization of care. A retrospective cohort study was performed, including cCP patients diagnosed between 2004 and 2021. Treatment characteristics and hypothalamic outcomes were evaluated and compared before and since centralization of care in May 2018. We included 87 cCP patients. Cyst drainage/fenestration was performed in 29.9%, limited resection in 27.6%, near-total resection in 16.1%, and gross total resection (GTR) in 25.4%. Radiotherapy was given in 46.0%. After a median follow-up of 6.5 years, hypothalamic obesity (HO) was present in 24.7% and panhypopituitarism with diabetes insipidus in 71.3%. Higher body mass index (BMI) SDS at diagnosis and Muller grade II at last magnetic resonance imaging of follow-up were associated with overweight/obesity. No association was found between extensiveness of resection and overweight/obesity at last follow-up. When comparing before and after centralization of care, rates of GTR remained similar, but BMI outcomes changed; mean ΔBMI SDS 1 year after diagnosis from 1.12 (SD 1.15) to 0.81 (SD 1.24), and HO after 1 year decreased from 33.3% to 12.0% (P = .067), and after 2 years from 28.6% to 6.7% (P = NS). In our nationwide cohort, GTR was performed in a relatively low percentage of patients and extensiveness of resection was no longer associated with HO at follow-up. A trend toward improvement of BMI is observed since centralization of care, which needs further exploration.

Schaaf-Yang Syndrome: Clinical Phenotype and Effects of 4 years of Growth Hormone Treatment

Introduction: Schaaf-Yang syndrome (SYS) is a rare neurodevelopmental disorder caused by truncating mutations of the MAGEL2 gene, located in the Prader-Willi syndrome (PWS) region. PWS and SYS have phenotypic overlap. Patients with SYS are often treated with growth hormone (GH), but evidence for the effectiveness of the treatment in patients with SYS is limited. Methods: This study describes 7 children with SYS. We studied their phenotype, genotype, and the effect of GH treatment on height and body mass index (BMI) during 4 years and on body composition during 1 year. Results: All patients had a normal birth weight. Most patients had hypotonia and feeding difficulties after birth (86%). Full-scale IQ ranged from <50 to 92. All patients above the age of 2 years had psycho-behavioral problems. There were no apparent correlations between the phenotype and the location of the defect in the MAGEL2 gene. Mean (95% CI) height SDS increased significantly from −1.74 (−3.55; 0.07) at start to −0.05 (−1.87; 1.77) after 4 years of GH treatment. Mean (95% CI) BMI SDS decreased significantly from 2.01 (1.02; 3.00) to 1.22 (0.18; 2.26) after 6 months and remained the same during the rest of the follow-up. Fat mass percentage SDS decreased and lean body mass did not change during 1 year of treatment in 3 patients. Conclusion: Patients presented with a phenotype of hypotonia, respiratory insufficiency, and feeding difficulties after birth, endocrine disorders, intellectual disability, and behavioral problems. Treatment with GH significantly improved height SDS and BMI over the course of 4 years.

Partial meniscectomy using needle arthroscopy associated with significantly less pain and improved patient reported outcomes at two weeks after surgery: A comparison to standard knee arthroscopy

Purposeto compare immediate post-operative pain and patient-reported outcomes (PROs) after partial meniscectomy with needle (NA) vs. standard (SA) arthroscopy technique. MethodsA retrospective review of a consecutive series of patients who underwent partial meniscectomy before and after adoption of a needle arthroscopic technique was performed. Meniscus repairs, root repairs, and those with ligamentous injuries were excluded. Total milligram morphine equivalents (MMEs) consumed, Visual analog scale (VAS) pain, and Knee Injury and Osteoarthritis Outcome Scores (KOOS) were compared pre-operatively and at 2 and 6-weeks postoperatively. Univariate analysis was used to compare results. ResultsNineteen patients were in each group (NA: 10 females, SA: 11 females). Mean ± SD age (NA 42.8 ± 8.4 vs. SA 47.6 ± 10.4 years, p = 0.13) and body mass index (NA 31.4 ± 5.6 vs. SA 35.1 ± 5.4 m/kg2, p = 0.06) were not significantly different. Seventeen (89%) patients in both groups had medial meniscus tears of the posterior horn. Preoperative Outerbridge score was significantly greater in the SA group (3.4 vs. 1.8, p = 0.002); however, preoperative VAS pain (NA 6.1 ± 1.7 vs. SA 6.1 ± 1.8, p = 0.98) and KOOS pain (NA 44 ± 17% vs. SA 37 ± 12.5%, p = 0.20) were similar. Amount of arthroscopic fluid used was significantly greater in the SA vs. NA group (1.4 ± 0.7 vs. 0.5 ± 0.3 L, p < 0.0001), but tourniquet time was equivalent (NA 20 ± 6 vs.16 ± 6 min, p = 0.11). VAS pain scores (NA 1.0 ± 1.1 vs. SA 2.6 ± 1.5, p = 0.0014), KOOS pain (NA 79 ± 15% vs. 58 ± 19%, p = 0.0006), and Quality of Life (QOL) scores (NA 70 ± 22% vs. SA 43 ± 24%, p = 0.001) were significantly better at 2-weeks post-op in the N group. By 6 weeks post-op, all PROs including VAS pain and KOOS scores were similar between groups. ConclusionsAdoption of a needle arthroscopic technique for partial meniscectomy was associated with significantly improved VAS and KOOS pain scores two-weeks post-operatively. Differences were not sustained at 6 weeks after surgery. Level of evidenceIII, Retrospective Comparison Study.

Epidemiologic effectors on the breast tumor microenvironment: Results from the Cancer Prevention Study-II and -3 cohorts.

10530 Background: Despite breast cancer being the leading cancer among women, we have a poor understanding of the impact of epidemiologic risk factors on its tumor microenvironment (TME). We examined risk factors for TME favorability using a novel aggregate marker: the Histomic Prognostic Score (HiPS). Methods: Data were from whole slide image (WSI) scans of hematoxylin &amp; eosin slides from women in the Cancer Prevention Studies CPS-II and -3, diagnosed with nonmetastatic breast cancer. Diagnoses occurred between enrollment and the last administrative date (1992/1993 to 2011 in CPS-II and 2006–2013 to 2018 in CPS-3). Median year of diagnosis was 2004 in CPS-II and 2014 in CPS-3. Using the WSI, a deep-learning model was trained to extract features and summarize the morphology of the epithelium, stroma, and tumor-infiltrating lymphocytes within the TME. These features, along with demographic, tumor biomarkers, and survival data, were then used to generate the HiPS, a novel measurement of “ prognostic favorability” of TME, ranging from 0 (favorable) to 10 (unfavorable). Multivariable linear models estimated associations between the HiPS score and epidemiologic risk factors: hormone replacement therapy use (HRT; current vs. former/never), cigarette smoking (current vs. former/never), alcohol intake (&gt;1 drink vs. &lt;1 drink/day), aspirin intake (daily vs. not daily) controlled for, age at diagnosis, body mass index (BMI), race, and cancer detection method (screen- vs. self-detected). Results: We included 1264 CPS-II and 651 CPS-3 participants in the analysis. Compared to CPS-II, CPS-3 participants were younger (mean (± sd) age 54.7 ± 7.6 vs. 72.2 ± 7, p&lt;0.001), heavier (mean (± sd) BMI 27.1 ± 5.8 vs. 26 ± 4.8, p&lt;0.001), and more diverse (7.4% vs. 2.1% non-White, p&lt;0.001). Most breast cancers (69.9% of CPS-II and 64.1% of CPS-3) were screen-detected, p=0.206. Increasing age and BMI were associated with higher HiPS score in both cohorts, Table. Daily aspirin use and current HRT use were associated with lower HiPS scores in CPS-3 only. The inverse association for HRT use was lost in the following subgroups age &lt; 50, ER-, HER2+, TNM stage-1, and screen-detected cancers. Conclusions: Increasing age and BMI have independent adverse effects on breast TME. Daily aspirin intake and current HRT use were only associated with a favorable TME in the younger, more contemporary cohort. Additional studies are needed to confirm these findings and better understand the role of these epidemiologic factors on the TME. [Table: see text]

Effect of Obesity on Surgical Outcomes of Lumbar Microdiscectomy: A Retrospective Analysis of 525 Patients.

Obesity has been implicated in higher rates of intra-operative complications, as well as increased risk for recurrent herniation and re-operation following lumbar microdiscectomy (LMD). However, the current literature is still controversial about whether obesity adversely affects surgical outcomes, especially a higher re-operation rate. In this study, we have compared surgical outcomes such as recurrence of symptoms, recurrence of disc herniation, and re-operation rates in obese and non-obese patients undergoing one segment LMD. A retrospective review was conducted on patients undergoing single-level LMD between 2010-2020 at an academic institution. Exclusion criteria included prior lumbar surgery. Outcomes assessed included the presence of persistent radicular pain, imaging evidence of recurrent herniation, and the need for re-operation due to recurrent herniation. A total of 525 patients were included in the study. The mean±SD body mass index (BMI) was 31.2±6.6 (range 16.2-70.0). The mean follow-up was 273.8±445.2 days (range 14-2494). Reherniation occurred in 84 patients (16.0%), and 69 (13.1%) underwent re-operation due to persistent recurrent symptoms. Neither reherniation nor re-operation was significantly associated with BMI (p = 0.47 and 0.95, respectively). Probit analysis did not show any significant association between BMI and the need for re-operation following LMD. Obese and non-obese patients experienced similar surgical outcomes. Our results showed that BMI did not adversely affect reherniation or re-operation rate following LMD. If clinically indicated, LMD can be performed in obese patients with disc herniation without a significantly higher re-operation rate.

Decline in the Age of Menarche in İstanbul Schoolgirls Over the Last 12 Years.

Menarche is the endpoint of a sequence of maturational events of female puberty. The timing of menarche is a strongly heritable trait. However, secular trends suggest that lifestyle and environmental factors are important. To assess the trend in age at menarche (AAM), and its associated factors in Istanbul over the last 12 years. A cross-sectional study was carried out between March and April 2022 on schoolgirls aged 9-18 years. A predesigned and self-administered questionnaire was filled out anonymously by the students. The data of AAM was included in the statistical analysis if the time of AAM is remembered for months and years. A probit model was used to calculate the median AAM. The findings were compared with those from the study performed 12 years ago in the same region of Istanbul. Among 9000 girls to whom the questionnaire was distributed, 1749 (19.5%) responded. The median AAM of 1374 girls whose AAM information was considered valid was 12.04 years (95% CI 12.01-12.13), 0.7 years lower than was reported 12 years ago (p<0.0001). AAM was correlated positively with maternal AAM, and negatively with body mass index (BMI) SDS and maternal educational status (p<0.0001, <0.0001, 0.002), respectively. There was no correlation between the AAM and birth weight. Girls with BMI percentile ≥85% (n=251) had earlier menarche than the ones with BMI percentile <85% (n=1072) (11.5 vs. 12.1 years, p<0.0001). Among the mother-daughter pairs (n=1162), AAM of girls was 0.91 years (median 0.94 years) earlier than their mothers. The present study demonstrates a significant downward trend in the menarcheal age in Istanbul over the last decade. Our findings support a strong contribution of genetic factors and BMI on AAM.

Effectiveness and Safety of iGlarLixi in People with Type 2 Diabetes in Adriatic Region Countries: ENSURE-ADR, a Real-World Study.

The efficacy of iGlarLixi, a fixed-ratio combination of basal insulin glargine 100 units/mL (iGlar) and the short-acting GLP-1 RA lixisenatide (Lixi), was established in people with type 2 diabetes (T2D) who were advancing therapy from oral antidiabetic drugs (OADs) and basal insulin (BI). This retrospective study aimed to evaluate the effectiveness and safety of iGlarLixi using real-world data from people with T2D in the Adriatic region countries. This was a non-interventional, retrospective, multicenter, cohort study with the collection of pre-existing data at iGlarLixi initiation and after 6months of treatment in real-world clinical and ambulatory settings. The primary outcome was the change in glycated hemoglobin (HbA1c) at 6months after iGlarLixi initiation. Key secondary outcomes included the proportion of people achieving HbA1c < 7.0%, the effect of iGlarLixi on fasting plasma glucose (FPG), body weight and body mass index (BMI). In this study, 262 participants (130 in Bosnia and Herzegovina, 72 in Croatia and 60 in Slovenia) initiated treatment with iGlarLixi. The participants had a mean ± SD age of 66.2 ± 7.9years and the majority were women (58.0%). The mean baseline HbA1c was 8.9 ± 1.7% and the mean body weight was 94.3 ± 18.0kg. After 6months of treatment, the reduction in the mean HbA1c was statistically significant (1.11 ± 1.61%, 95% confidence internal [CI] 0.92, 1.31; p < 0.001), and the proportion of participants who achieved HbA1c < 7.0% had significantly increased from baseline (8.0-26.0%, p < 0.001). The change in mean FPG (mmol/L) levels was significant (2.7 ± 4.4 [95% CI 2.1, 3.2; p < 0.001]). The mean ± SD body weight and BMI were significantly reduced by 2.9 ± 4.3kg (95% CI 2.3, 3.4; p < 0.001) and 1.3 ± 4.4kg/m2 (95% CI 0.7, 1.8; p < 0.001), respectively. Two serious hypoglycemia episodes and one adverse gastrointestinal effect (nausea) were registered. This real-world study demonstrated the effectiveness of iGlarLixi for improving glycemic control and decreasing body weight in people with T2D who need to advance therapy from OADs or insulin.

Dietary advanced glycation end products are associated with an increased risk of non-alcoholic fatty liver disease in Iranian adults

BackgroundDietary advanced glycation end products(AGEs) may contribute to increased inflammation and oxidative stress as risk factors for chronic diseases such as liver disease. In the current study, we aimed to examine the possible association of dietary AGEs with the odds of non-alcoholic fatty liver disease (NAFLD) in Iranian adults.MethodsA total of 675 participants (225 newly diagnosed NAFLD cases and 450 controls), aged 20–60 years, were recruited for this case-control study. Nutritional data were measured using a validated food frequency questionnaire, and dietary AGEs were determined for all participants. An ultrasound scan of the liver performed the detection of NAFLD in participants of the case group without alcohol consumption and other causes of hepatic disorders. We used logistic regression models, adjusted for potential confounders, to estimate the odds ratios(ORs) and 95% confidence interval(CI) of NAFLD across tertiles of dietary AGEs.ResultsMean ± SD age and body mass index of the participants were 38.13 ± 8.85 years and 26.85 ± 4.31 kg/m2, respectively. The median(IQR) of dietary AGEs in participants was 3262(2472–4301). In the sex and age-adjusted model, the odds of NAFLD were increased across tertiles of dietary AGEs intake(OR:16.48;95%CI:9.57–28.40, Ptrend<0.001). Also, in the final model, after controlling for confounding effects of BMI, smoking, physical activity, marital status, socio-economic status, and energy intake, the odds of NAFLD were increased across tertiles of dietary AGEs intake(OR:12.16; 95%CI:6.06–24.39, Ptrend<0.001).ConclusionOur results showed that greater adherence to dietary pattern with high dietary AGEs intake was significantly related to increased odds of NAFLD.

Frequency and risk factors of simple obesity in children with bronchial asthma

Currently, it has been established that obesity in children with bronchial asthma leads to a more severe course of the disease, a worse quality of life, and a reduced response to treatment.Purpose. To study the incidence and risk factors of simple obesity in children with bronchial asthma. The aim of the study was to study the incidence and risk factors of simple obesity in children with bronchial asthma.Material and methods. The study included 484 patients aged 7 to 14 years: the main group consisted of 237 patients with atopic bronchial asthma, the comparison group consisted of 247 children without a diagnosis of bronchial asthma.Results. Patients of the main group were obese more often (18.9%) than children of the comparison group (11.3%, p=0.019). During 5 years of bronchial asthma disease, a tendency (p=0.087) was revealed to increase the SDS body mass index indicator in the dynamics of the disease (from 0.32 to 0.45) and the number of patients with III and IV degrees of obesity (from 10.5% to 42.8%, p=0.025). In children of the main group with normal SDS body mass index before the diagnosis of bronchial asthma 5 years after the onset of the disease, in 8.5% of cases there was obesity (p&lt;0.001) and in 23.9% — excess body weight (p&lt;0.001), in children with initial excess body weight, obesity was diagnosed in 28.6% of cases (p=0.048), and among children who were obese at the time of bronchial asthma, 26.3% had an increase in its severity (p=0.023). In patients with bronchial asthma and obesity, according to the bioimpedance analysis findings, a pronounced imbalance between energy intake and its consumption was revealed, and according to the nutrition assessment data — an unbalanced diet, a violation of the diet and a sedentary lifestyle.Conclusion. Simple obesity occurs in 18.9% of school-age children with atopic bronchial asthma, and over the course of 5 years of the disease, the number of patients with obesity increases and its severity progresses. Therefore training of patients and their parents, correction of nutrition and increasing the volume of physical activity are an important component of treatment.