Elements In Patients Research Articles

Serum Trace Elements in Patients With Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis.

Polycystic ovary syndrome (PCOS) is reported to be associated with certain trace elements. However, previous data are inconsistent and potentially biased due to small sample sizes. The potential utility of trace element levels for screening of PCOS remains to be established. The aim of this meta-analysis was to investigate the potential relationships between PCOS and serum levels of zinc (Zn), copper (Cu), magnesium (Mg), iron (Fe) and ferritin. We carried out a literature search of PubMed, EMBASE, and Web of Science for relevant cross-sectional/case-control studies published prior to October 2019. Random-effect models were used to estimate the overall standard mean differences (SMDs) between PCOS and healthy control subjects. The screening value of potential microelement biomarkers for PCOS was assessed using the receiver operating characteristic (ROC) curve. Twenty-one studies featuring 2,173 women with PCOS and 1,897 healthy women were selected for analysis. Our results showed that Cu and ferritin levels were significantly higher in women with PCOS than healthy controls, with SMDs of 0.52 [95% confidence interval (CI): 0.38–0.67, I2 = 47.6%] and 1.05 (95% CI: 0.25–1.86, I2 = 97.0%), respectively. The serum ferritin concentration was distinguished as a potential biomarker for PCOS based on the high area under ROC curve value of 0.71 (95% CI: 0.57–0.86). Although we did not identify a statistical association between serum Zn concentration and PCOS overall, the concentration of Zn in PCOS women with insulin resistance (IR) was lower than that in healthy women (SMD = −0.89, 95% CI: −1.73 to −0.06). Furthermore, the concentrations of Mg (SMD = 0.31, 95% CI: −0.32–0.94, I2 = 95.4%) and Fe (SMD = −0.59, 95% CI: −1.29–0.12, I2 = 97.2%) were not statistically significant between the PCOS and control groups. We generated hypothetical pathways for associations among serum Cu, ferritin and PCOS. The serum concentrations of both Cu and ferritin were significantly higher in women with PCOS, and ferritin was identified as a potential early indicator for PCOS screening. Further studies are essential to determine the specific underlying mechanisms.

Effects of integrated traditional Chinese and western medicine on the vision recovery and serum trace elements of patients with herpes simplex keratitis

Objective: To explore the effects of integrated traditional Chinese and western Medicine on the vision recovery and serum trace elements in patients with herpes simplex keratitis.Methods: A total of 86 cases of HSK patients admitted in Baogang Hospital of Inner Mongolia from January 2015 to October 2016 were selected and divided randomly into the observation group (n = 43) and the control group (n = 43) according to the random number table. The control group was treated with ganciclovir eye drops and chondroitin sulfate eye drops, and the observation group was treated with Qinggan Mingmu Decoction on the basis of the control group. The 2 groups were treated for 4 weeks continuously. The clinical efficacy was compared between two groups. The vision recovery, serum trace elements and tear immune factor levels were also compared between two groups before and after treatment.Results: After treatment, the effective rate of treatment in the observation group was significantly higher than that in the control group (p < .05); in the observation group of patients, visual analogue scale (VAS) score and visual acuity after treatment were obviously higher than those before treatment, and also remarkably higher than those in the control group of patients (p < .05); after treatment, the levels of Fe, Ca and Cu ions in the observation group were significantly lower than those in the control group and before treatment (p < .05); after treatment, the level of zinc ions in the serum in the observation group was significantly higher than that before treatment and in the control group (p < .05); after treatment, the levels of tear IgA, IgG and C3 in the observation group were prominently higher than those before treatment and in the control group (p < .05).Conclusions: In the treatment of HSK, integrated traditional Chinese and western medicine can promote effectively the vision recovery, regulate the level of trace elements in the serum and enhance the level of tear immune factors, with the clinical efficacy better than the treatment of western medicine alone.

Psychedelic Treatments for Psychiatric Disorders: A Systematic Review and Thematic Synthesis of Patient Experiences in Qualitative Studies.

IntroductionInterest in the use of psychedelic substances for the treatment of mental disorders is increasing. Processes that may affect therapeutic change are not yet fully understood. Qualitative research methods are increasingly used to examine patient accounts; however, currently, no systematic review exists that synthesizes these findings in relation to the use of psychedelics for the treatment of mental disorders.ObjectiveTo provide an overview of salient themes in patient experiences of psychedelic treatments for mental disorders, presenting both common and diverging elements in patients’ accounts, and elucidating how these affect the treatment process.MethodsWe systematically searched the PubMed, MEDLINE, PsycINFO, and Embase databases for English-language qualitative literature without time limitations. Inclusion criteria were qualitative research design; peer-reviewed studies; based on verbalized patient utterances; and a level of abstraction or analysis of the results. Thematic synthesis was used to analyze and synthesize results across studies. A critical appraisal of study quality and methodological rigor was conducted using the Critical Appraisal Skills Programme (CASP).ResultsFifteen research articles, comprising 178 patient experiences, were included. Studies exhibited a broad heterogeneity in terms of substance, mental disorder, treatment context, and qualitative methodology. Substances included psilocybin, lysergic acid diethylamide (LSD), ibogaine, ayahuasca, ketamine and 3,4-methylenedioxymethamphetamine (MDMA). Disorders included anxiety, depression, eating disorders, post-traumatic stress disorder, and substance use disorders. While the included compounds were heterogeneous in pharmacology and treatment contexts, patients reported largely comparable experiences across disorders, which included phenomenological analogous effects, perspectives on the intervention, therapeutic processes and treatment outcomes. Comparable therapeutic processes included insights, altered self-perception, increased connectedness, transcendental experiences, and an expanded emotional spectrum, which patients reported contributed to clinically and personally relevant responses.ConclusionsThis review demonstrates how qualitative research of psychedelic treatments can contribute to distinguishing specific features of specific substances, and carry otherwise undiscovered implications for the treatment of specific psychiatric disorders.

The rationale for a multi-step therapeutic approach based on antivirals, drugs and nutrients with immunomodulatory activity in patients with coronavirus-SARS2-induced disease of different severities.

In December 2019, a novel human-infecting coronavirus, named Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2), was recognised to cause a pneumonia epidemic outbreak with different degrees of severity in Wuhan, Hubei Province in China. Since then, this epidemic has spread worldwide; in Europe, Italy has been involved. Effective preventive and therapeutic strategies are absolutely required to block this serious public health concern. Unfortunately, few studies about SARS-CoV-2 concerning its immunopathogenesis and treatment are available. On the basis of the assumption that the SARS-CoV-2 is genetically related to SARS-CoV (about 82 % of genome homology) and that its characteristics, like the modality of transmission or the type of the immune response it may stimulate, are still poorly known, a literature search was performed to identify the reports assessing these elements in patients with SARS-CoV-induced infection. Therefore, we have analysed: (1) the structure of SARS-CoV-2 and SARS-CoV; (2) the clinical signs and symptoms and pathogenic mechanisms observed during the development of acute respiratory syndrome and the cytokine release syndrome; (3) the modification of the cell microRNome and of the immune response in patients with SARS infection; and (4) the possible role of some fat-soluble compounds (such as vitamins A, D and E) in modulating directly or indirectly the replication ability of SARS-CoV-2 and host immune response.

Current Trends of Essential Trace Elements in Patients with Chronic Liver Diseases.

Essential trace elements play crucial roles in the maintenance of health, since they are involved in many metabolic pathways. A deficiency or an excess of some trace elements, including zinc, selenium, iron, and copper, frequently causes these metabolic disorders such as impaired glucose tolerance and dyslipidemia. The liver largely regulates most of the metabolism of trace elements, and accordingly, an impairment of liver functions can result in numerous metabolic disorders. The administration or depletion of these trace elements can improve such metabolic disorders and liver dysfunction. Recent advances in molecular biological techniques have helped to elucidate the putative mechanisms by which liver disorders evoke metabolic abnormalities that are due to deficiencies or excesses of these trace elements. A genome-wide association study revealed that a genetic polymorphism affected the metabolism of a specific trace element. Gut dysbiosis was also responsible for impairment of the metabolism of a trace element. This review focuses on the current trends of four trace elements in chronic liver diseases, including chronic hepatitis, liver cirrhosis, nonalcoholic fatty liver disease, and autoimmune liver diseases. The novel mechanisms by which the trace elements participated in the pathogenesis of the chronic liver diseases are also mentioned.

Patients’ experiences with fluctuations in persistent physical symptoms: a qualitative study

ObjectivesTo explore patients’ experiences with fluctuations in persistent physical symptoms (PPS) and to understand which factors—from their viewpoint—play a role in these fluctuations.DesignQualitative study using semistructured interviews and thematic content...

Oxidative Stress and Trace Elements in Pulmonary Tuberculosis Patients During 6Months Anti-tuberculosis Treatment.

Pulmonary tuberculosis (TB) is a well-known cause of imbalance in oxidative stress (OS) status and trace element levels. However, little information is available for targeting the correlation between OS and trace elements in pulmonary TB patients. The aim of our study was to analyze the OS status and its correlation with trace elements in patients initially and during 6months anti-TB treatment. Eighty-six newly diagnosed pulmonary TB patients were consecutively recruited, and 112 age- and sex-matched healthy controls participated in the study. Serum markers of OS and trace elements levels were tested and analyzed in all subjects during 6months anti-TB treatment. Compared with healthy controls, significantly increased level of malondialdehyde (MDA), decreased glutathione (GSH) level, superoxide dismutase (SOD), and catalase (CAT) activities were found in TB patients. The activities of SOD and CAT and GSH level recovered till normal range at treatment final. Zinc (Zn), selenium (Se), and copper (Cu) concentrations were significantly lower in TB patients in comparison with healthy controls, whereas Zn, Cu, and Se concentrations rise during 6months anti-TB treatment. Zn was positively correlated with Cu, Se, and GSH, while MDA was negatively correlated with Zn, Se, SOD, and CAT, and SOD was positively correlated with Cu, Zn, and CAT. Our findings indicate that anti-TB treatment could reduce the status of OS and increase the levels of trace elements. The routine assessment of OS markers and element traces may guarantee improved monitoring the anti-TB treatment.

Update Resuscitation - In-hospital Cardiac Arrest

The structure of emergency care is a key element for patients' safety in hospital. Early warning scores and the implementation of medical emergency teams (MET) can help to detect deteriorating patients early and prevent unexpected deaths. This article summarizes essential elements of a modern emergency management in hospitals.

STUDY OF ACTIVATING EFFECT OF SURFACTANT DRUGS ON PULMONARY MACROPHAGES IN VITRO IN PATIENTS WITH BRONCHIECTASIS

The state of surfactant system of lungs in chronic inflammation is known to disrupt their structural organization, causes shifts in the system itself, the severity of which depends on alveolar parenchyma injury rate. The cell destruction of aerohematical barrier is accompanied by changes in pulmonary surfactant system, its deficiency, development of dis− and atelectases, which increases the severity of lung injury and promotes the progression of bronchiectasis. Exogenously introduced surfactant restores local immunity and serves as a substrate for synthesis of its own surfactant. To determine the stimulatory effect of natural surfactant on receptors of the lung macrophages and its influence on activation of phagocytosis a comparative study of direct effect of infasurf on cell surface and formation of phagocytic vacuoles in macrophage elements of individuals with bronchodectic disease at an acute stage was performed . In bronchoalveolar lavage of patients the percentage and viability of pulmonary macrophages were determined. Other lavage material was investigated both as a baseline control and with infasurf. The electron microscopic examination of bronchoalveolar lavage macrophage elements in patients show that after incubation of cells with infasurf, there is a pronounced cell surface activation, formation of phagocytic vacuoles containing membranes of exogenous surfactant. Its small and large clusters were often observed lying freely between pulmonary macrophages, whereas in the control group (without infasurf) small fragments of tubular myelin or osmiophilous lamellar bodies were noted. Thus, the specific pharmacological action of surfactant drugs directly contributes to differentiation and maturation of pulmonary macrophages, their phagocytic function activation. Key words: bronchiectasis, surfactant, pulmonary macrophages.

Study of the Effect of Proton Pump Inhibitors on the Development of Hypomagnesemia in Patients with Paroxysmal Atrial Fibrillation on the Background of Autonomic Sinus Node Dysfunction

Aim. To study the effect of proton pump inhibitors (PPIs) on the development of hypomagnesemia in patients with paroxysmal atrial fibrillation (AF) on the background of autonomic sinus node dysfunction (ASND).Material and methods. A prospective cohort study included 32 patients with an established diagnosis of ASND and often recurrent paroxysmal AF. The main group consisted of 17 patients who took pantoprazole at a dose of 20 mg 2 times a day as treatment of diagnosed duodenal erosions within 6 weeks from the time of the initial visit to an arrhythmologist. The remaining 15 patients did not take PPIs and were included in the control group. The determination of magnesium in whole blood, plasma and formed elements was carried out twice in all patients – at the initial visit and after 6 weeks. In addition, in the experiment, complex-forming activity of solutions of various PPIs (esomeprazole, pantoprazole, rabeprazole and omeprazole) with respect to magnesium ions was studied. The author’s method was used, based on turbidimitric determination of the light transmission during the heterogeneous reaction of the formation of magnesium phosphates in the presence of the analyzed drug or without it.Results. There were no significant differences in the magnesium content in the blood of patients of the main and control groups before taking PPIs. After taking of pantoprazole by the patients of the main group there were significant differences between main and control groups in magnesium in whole blood (0.48 [0.44-0.51] mmol/l vs 0.55 [0.5-0.61] mmol/l, p=0.01) and its values in formed elements (0.52 [0.45-0.67] mmol/l vs 0.75 [0.65-1.2] mmol/l, p=0.009). Analysis of magnesium content in patients of the main group before and after taking of pantoprazole also showed a significant decrease in intracellular concentrations of the element (0.6 [0.51-1.0] mmol/l vs 0.52 [0.45-0.67] mmol/l, p=0.002), as well as decrease in its total content in whole blood (0.51 [0.45-0.59] mmol/l vs 0.48 [0.44-0.51] mmol/l, p=0.04). To substantiate the observed effects it was experimentally proved the possibility of formation of strong complex compounds between the ions of magnesium and PPIs: the highest activity was demonstrated by rabeprazole and pantoprazole (coefficients of complex formation per unit of total organic carbon – 1.5 and 0.72, respectively) and the lowest – omeprazole and esomeprazole (0.04 and 0.09, respectively).Conclusion. A decrease of magnesium content in whole blood and formed elements in patients with paroxysmal AF on the background of ADSN was mediated by a six-week intake of pantoprazole in a dose of 20 mg 2 times a day for the treatment of concomitant erosion of the duodenum. When choosing PPIs for arrhythmological patients with concomitant gastro-duodenal pathology, it is advisable to be guided by the complexing activity of drugs with respect to magnesium ions: the most pronounced metal-ligand interaction with magnesium was shown by rabeprazole and pantoprazole, and the least – omeprazole and esomeprazole.

Metabolic syndrome and COVID-19

At the end of last year, a new strain of coronavirus emerged in China, which was called SARS-CoV-2. The virus quickly spread throughout the world, reaching pandemic proportions, and is now considered a worldwide public health emergency. In line with this, several studies aimed to postulate and elucidate possible risk factors involved not only in the genesis of coronavirus disease 2019 (COVID-19) but also in the susceptibility and severity of the condition. Among the most reported elements in patients with a more critical clinical scenario and adverse outcomes is metabolic syndrome (MS), a condition consisting of chronic diseases such as obesity, type 2 diabetes mellitus, dyslipidemia, and systemic arterial hypertension. In this light, this work aims to build a descriptive review of the relationship between the factors inherent to MS and COVID-19, in order to better clarify the mechanisms belonging to this association. Resistance to the action of insulin caused by centripetal obesity is permeated by an environment abundant in pro-inflammatory cytokines, which favors the immune imbalance, leading to the modulation of dysfunctional and inefficient responses. Besides, it is important to mention the overlapping of inflammatory secretory patterns of MS with the cytokine storm of COVID-19, leading to a worse prognosis. SARS-CoV-2 and arterial hypertension share pathways through a common enzyme: ACE2, widely expressed in the respiratory epithelium and belonging to the pressure regulation cascade. However, dyslipidemia promotes higher morbidity and mortality through increased cardiovascular risk due to thrombotic events. In short, MS represents a critical element to be considered through association with COVID-19, since it interferes in greater severity and mortality through several factors.

Mapping of supernumerary elements in patients seeking orthodontic treatment

Introduction: Dimension, number and shape alterations are frequently observed dental anomalies. Objective: The aim of this study was to map the frequency, the preferred location and the most prevalent types of supernumerary teeth, in the studied population. In addition, to assess the interference that supernumeraryteeth may cause in the ectopic eruption of the normal dental series teeth. Methods: This is an observational retrospective study. Data collection was performed by evaluation of dental records of patients treated in an orthodontic clinic. Patients‘ radiographs, photographs and gypsum dental models were analyzed and datarecorded in protocol files, by previously trained undergraduate and postgraduate students. Records from 1984 to 2019 were evaluated, and evaluation lasted two months. Data were stored in Microsoft Office Excel (version 2016) for descriptive analysis. Results: From the 920 patients’ records analyzed, 2.7% presented atleast one supernumerary tooth, with preferred location on the anterior maxillary area and mandibular parapremolar area. The most prevalent type was the supplemental tooth, with normal eruption orientation and normal alveolar location. Conclusion: The supernumerary teeth of the studied population showedlittle interference in the ectopic eruption of the normal dental series. Most of the supernumerary teeth were impacted, and, approximately one third of the supernumerary teeth showed deviated eruptions.

Factors affecting empathy among indian dentists.

Empathy is one of the major essential elements in patient and dentist relationship. Interpersonal Reactivity Index (IRI) has been used extensively to measure empathy among medical and other health professions. However, its validity in dental profession remains to be explored. To examine the psychometric properties of IRI and also to assess the factors influencing the dental students' empathy. A cross-sectional questionnaire study was carried out among 100 dental interns and postgraduates using IRI. Patients were selected randomly from six dental colleges in Bangalore. Internal consistency of items was evaluated by Cronbach's alpha and construct validity was assessed by confirmatory factor analysis with an orthogonal varimax rotation of factors. The data were evaluated using SPSS 22. Descriptive and inferential statistics were performed with significance set at 5%. Internal consistency of IRI (Cronbach's alpha: perspective taking = 0.76, fantasy = 0.80, empathic concern = 0.72, and personal distress = 0.79) was good. A four-factor solution emerged, accounting for 52% of total variance. The mean age of the participants was 24.25 ± 1.95 years. The mean for empathic concern domain was highest (20.75 ± 1.64). Gender, career choice, academic performance, and work satisfaction were associated with increased empathy scores, whereas depression and stress were associated with decreased empathy scores (P < 0.05). This study confirms the construct validity and reliability of the IRI for assessing empathy in dental students. Empathy scores among students varied depending on professional/personal factors.

Stress and Stroke: Psychological Approach Patients in Middle Hospitalier

Introduction: Human beings are confronted with several trying situations that generate stress. Psychopathological manifestations such as anxiety, anxiety, depression, appear as an imbalance in the personality of individuals. Stroke and its increasing frequency in terms of death but especially morbidity has become one of the leading sources of disability in the world. Its appearance is medically described as caused by vascular risk factors. Our goal was to study the impact of stress on the onset and worsening of a stroke. Methodology: This was the clinical method, the aim of which was to identify any stressful event in the patient’s life and its psychological consequences in order to establish a link between the impact of stress and the stroke; of the semi-directive clinical interview in order to leave the subject a great possibility of expression on the themes associated with our objective then the inferential descriptive method for the evaluation of psychological factors using several scales including The CISS and the STAI. The inclusion criteria were the existence of a stroke, and the existence of a good state of cognitive functions. Results: In our summary analysis, it appears that the stroke would result from chronic stress objectively detected by coping from the CISS and the STAI. The most stressful events on the Holmes and Rahe Scale were; on the family level: the death of a loved one, the illness of a loved one, incessant arguments, family tensions, family violence. On a personal level: illness, sentimental disappointment, abandonment; alcohol, drugs; and finally on the professional level, dismissal and professional conflict. Conclusion: Stress is a psychological factor that increases the occurrence of a stroke, but also constitutes a determining disturbing element in patients with one or more vascular risk factors.

The Copper/Zinc Ratio Correlates With Markers of Disease Activity in Patients With Inflammatory Bowel Disease.

BackgroundZinc (Zn) and copper (Cu) are trace elements that serve as cofactors in catalytic processes with impact on immune responses. In patients with inflammatory bowel disease (IBD), decreased levels of serum Zn and Cu have been observed. Here, we investigated the effect of inflammation on serum concentrations of these trace elements in patients with IBD.MethodsIn this cross-sectional study, 98 patients with Crohn disease (CD) and 56 with ulcerative colitis (UC) were prospectively enrolled. Disease activity parameters, such as C-reactive protein (CRP) and fecal calprotectin (FC) were compared to serum Zn, Cu, and Cu/Zn ratio.ResultsZinc insufficiency was observed in 11.2% of patients with CD and 14.3% with UC, Cu insufficiency in 20.4% with CD and 7.1% with UC. Anemia, hypoalbuminemia, increased FC, and elevated CRP were more frequently present in Zn-insufficient patients with IBD. In contrast, lower serum CRP values and a trend to lower FC were observed in Cu-insufficient patients. In multiple linear regression models adjusted for age, gender, and serum albumin, CRP positively correlated with serum Cu (P < 0.001) and the Cu/Zn ratio in both CD and UC (P < 0.001) but not with serum Zn concentrations. FC levels correlated only with the Cu/Zn ratio in patients with UC (P < 0.038).ConclusionSystemic inflammation inversely affected the serum Zn and Cu concentrations and, consequently, resulted in an increased Cu/Zn ratio.

Methylation hotspots evidenced by deep sequencing in patients with facioscapulohumeral dystrophy and mosaicism.

ObjectiveTo investigate the distribution of cytosine-guanine dinucleotide (CpG) sites with a variable level of DNA methylation of the D4Z4 macrosatellite element in patients with facioscapulohumeral dystrophy (FSHD).MethodsBy adapting bisulfite modification to deep sequencing, we performed a comprehensive analysis of D4Z4 methylation across D4Z4 repeats and adjacent 4qA sequence in DNA from patients with FSHD1, FSHD2, or mosaicism and controls.ResultsUsing hierarchical clustering, we identified clusters with different levels of methylation and separated, thereby the different groups of samples (controls, FSHD1, and FSHD2) based on their respective level of methylation. We further show that deep sequencing–based methylation analysis discriminates mosaic cases for which methylation changes have never been evaluated previously.ConclusionsAltogether, our approach offers a new high throughput tool for estimation of the D4Z4 methylation level in the different subcategories of patients having FSHD. This methodology allows for a comprehensive and discriminative analysis of different regions along the macrosatellite repeat and identification of focal regions or CpG sites differentially methylated in patients with FSHD1 and FSHD2 but also complex cases such as those presenting mosaicism.

Concentration of heavy metals and rare earth elements in patients with brain tumours: Analysis in tumour tissue, non-tumour tissue, and blood

ABSTRACT Inorganic elements have been associated with brain tumours for long. The blood concentration of 47 elements was assessed by ICP-MS in 26 brain tumour patients and 21 healthy subjects from Bucharest (Romania). All 47 elements were detected in the brain tumour tissue, and 22 were detected in > 80% of samples; this implies that these elements can cross the blood-brain barrier. Median blood levels of cadmium, lead, and nickel were higher than the reference values (1.14, 53.3, and 2.53 ng/mL). Gadolinium and tantalum showed significantly higher concentrations among cases. We observed considerable differences and different profiles of the presence of inorganic elements between the tumour and non-tumour brain tissue and between tissue from the primary tumour and tissue from brain metastasis. Our data suggest that similar to heavy metals, other elements – commonly used in high tech devices and rare earth elements – can also influence brain tumour.

Trace elements in saliva and plasma of patients with type 2 diabetes: Association to metabolic control and complications

AimAn analysis is made of the saliva and plasma levels of trace elements in patients with type 2 diabetes mellitus and their association to metabolic control and the presence of chronic complications. MethodsA cross-sectional observational clinical study was carried out in 74 patients with type 2 diabetes mellitus. Mass spectrometry (ICP-MS) was used to determine the following trace elements in plasma and unstimulated basal saliva: 13Al, 16S, 4Be, 5B, 20Ca, 27Co, 29Cu, 24Cr, 38Sr, 15P, 3Li, 12Mg, 25Mn, 28Ni, 82Pb, 37Rb, 22Ti, 23V and 30Zn. ResultsThe levels of cobalt (p = 0.048) in saliva and of strontium (p = 0.001) in plasma were related to the presence of chronic complications. Significant differences with respect to metabolic control were observed for beryllium (p = 0.038), boron (p = 0.023) and phosphorus in saliva (p = 0.046), and for rubidium (p = 0.005), titanium (p = 0.016) and zinc in plasma (p = 0.013). A significant correlation (p < 0.001) was found between boron in plasma and boron in unstimulated basal saliva. ConclusionsThe determination of trace elements in plasma and saliva constitutes a complementary tool for the assessment of metabolic control and for predicting chronic complications associated to type 2 diabetes mellitus. Further studies involving the biomonitoring of trace elements in saliva and plasma are needed.

1608P - Spirituality and religious coping for cancer patients and providers: An ‘Almighty’ belief for palliative care

BackgroundSpiritual distress is prevalent in advanced disease, but often neglected, resulting in unnecessary suffering. Religion and/or spirituality have increasingly been recognized as key elements in patients’ experience of advanced illness. This study aims to explore spiritual care needs, experiences, preferences and examine the association between religious coping and quality of life among patients with advanced cancer. MethodsStructured interviews were conducted with 135 patients in advanced cancer patients and their primary informal caregivers. Patients completed measures of QOL (McGill QOL questionnaire), religious coping (Brief Measure of Religious Coping [RCOPE] and Multidimensional Measure of Religion/ Spirituality), self-efficacy (General Self-Efficacy Scale), and sociodemographic variables. Both positive and negative religious coping and multiple dimensions of QOL (physical, physical symptom, psychological, existential, and support) were studied. ResultsThe median age of the population was 60.2 years and majority of the subjects were Hindus. The study revealed greater use of positive religious coping was associated with better overall QOL as well as higher scores on the existential and support QOL dimensions and was also related to more physical symptoms. However, greater use of negative religious coping was related to poorer overall QOL. Most patients believed it was important for health care professionals to consider patient spiritual concerns within the medical setting. Spiritual care was reportedly lacking, primarily due to staff members’ de-prioritisation and lack of time. ConclusionsThis study demonstrates that spiritual concerns are common among advanced cancer patients, and that they are associated with poorer psychological well-being. Spiritual care is an essential but neglected component of care, according to patients and their caregivers across a range of countries. The findings of the present study support the relationship between spirituality and health outcomes. Legal entity responsible for the studyVibhay Pareek. FundingHas not received any funding. DisclosureAll authors have declared no conflicts of interest.

The evaluation of serum micro and trace elements in patients with papillary thyroid carcinoma and multinodular goiter

The evaluation of serum micro and trace elements in patients with papillary thyroid carcinoma and multinodular goiter