Pre Values Research Articles

Nasikagra Drishti to enhance the selective attention on performance of six-letter cancelation task by young adults

Background: Nasikagra Drishti (ND), literally called as nose tip gazing, is one among the several practices in yoga. It comes under the Dharana division. Selective attention (SA) is an important function governed by the right frontoparietal cortex. The cancelation task requires visual selectivity as well as repetitive and coordinated motor responses. Six-letter cancelation task (SLCT) is effective in assessing functions, such as SA, visual scanning, inhibition and activation of rapid responses, and focused attention. Assessing SA among the young adults is highly helpful in evaluating their academic performance.Objective: The objective of the study is to assess the immediate and later effects of ND on SA in young adults using SLCT.Subjects and Methods: Thirty young adults of both sexes with 18.9 ± 1 years of mean age volunteered for the study. The SLCT data were collected before (pre), immediately after first session of the intervention (1st post), and after the 3rd-day intervention (2nd post) of ND.Results: The Student's t-test using STATA 12.0 (College station, Texas, USA) showed a significant increase in SA scores after the ND practice. The pre and immediate post values within the group were statistically significant at P < 0.001. The pre and later post (follow-up results) values within the group are also statistically significant at P < 0.001. However, the magnitude of change was more in the later postassessment than the preassessment and the immediate postassessment. Thus, it was revealed that ND practice can increase SA and thereby improves the academic performance.Conclusion: The present study suggests that the practice of ND may enhance SA among young adults and thus may prove beneficial for their academic performance. Additional well-designed studies are needed before a strong recommendation can be made on the efficacy of ND for enhancing SA, thereby improving academic performance.

Influence of acute high-intensity exercise on salivary nitric oxide levels.

This study, employing an exercise versus control crossover design, was conducted to investigate the influence of acute high-intensity exercise on salivary nitric oxide (NO) levels. Nine healthy males (aged 23.8 ± 1.4 years) performed ergometer exercise at 80%VO2peak for 60 min, whereas controls sat at rest for 60 min. Saliva samples were collected before (Pre: 0800 h) and after (Post 0-h: 0900 h, Post 1-h: 1000 h, Post 2-h: 1100 h, Post 3-h: 1200 h) the interventions. Salivary NO levels were determined by colorimetric assay. It was found that the salivary NO levels in controls were decreased (P < 0.05) at Post 0-h (-94 ± 15), Post 1-h (-80 ± 20), Post 2-h (-92 ± 34) and Post 3-h (-145 ± 39) relative to the Pre values. Under exercise conditions, salivary NO levels did not change after high-intensity ergometer exercise relative to the Pre values. Thus, the response of salivary NO levels appeared to differ between high-intensity ergometer exercise and inactivity, that exercise-related stress induces the production of salivary NO.

Blood loss following medial unicondylar knee replacements without a tourniquet: is there a need to group and save?

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; There are current trends towards not using a tourniquet in total knee replacement (TKR), but there is nothing published on what the effects of not using a tourniquet on unicondylar knee replacements (UKR) may be in terms of blood loss.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A retrospective case series of 36 consecutive UKR from our institution were analysed. All procedures were carried out without a tourniquet and also utilised a standardised interventions protocol including withholding of anticoagulants and antiplatelet medications, administration of periarticular local anaesthetic and adrenaline injection, and both IV and topical tranexamic acid. Outcomes measured were estimated intra-operative blood loss, overall blood loss through comparison of pre and post-operative haemoglobin laboratory values, and the need for post-operative blood transfusion.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Most patients (61.1%) experienced an estimated intra-operative blood loss of less than100 mls. There was a mean haemoglobin drop of 16.1 g/l (range 1–26, SD ±5.9), with a mean post operatively haemoglobin level of 125.1 g/l (range 107-142, SD ±8.7). No patients required a blood transfusion.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; A low level of blood loss is encountered when UKR is undertaken without a tourniquet and with our standard interventions to reduce bleeding. The level of post-operative haemoglobin and absence of requirement for blood transfusion suggests that this operation can be undertaken without the need for a group and save. It is our hope that surgeons will be encouraged to perform this procedure without a tourniquet and benefit from the cost-saving opportunity of not performing a group and save.&lt;/p&gt;

Effectiveness of laser acupuncture as adjunctive therapy for limited range of motion in rheumatoid arthritis

We evaluate the efficacy of laser acupuncture on the elbow range of motion in rheumatoid arthritis patients. Rheumatoid arthritis is the most common autoimmune inflammatory joint disease seen in clinical practice. Interventions for treating patients with rheumatoid arthritis are under investigation. Forty subjects in the age range of 50–60 years old were divided into two groups; each group consisted of twenty subjects. The first group had undergone laser acupuncture treatment. The other group consisted of healthy subjects, forming the control group. A computer vision system was used for elbow range of motion (ROM) measurement before and after 12 sessions of treatment. The results showed that the pre- and post-treatment mean values ±SD of elbow flexion ROM were 143.75 ± 2.68 and 144.89 ± 3.12°, respectively. The differences between pre and post treatment mean values ±SD of elbow flexion ROM was non-significant (P > 0.05). The pre and post treatment mean values ±SD of elbow extension ROM were 1.01° ± 4.01° and 3.07° ± 1.25°, respectively. The differences between pre- and post-treatment mean values ±SD of elbow extension ROM was significant (P < 0.05). It was concluded that laser acupuncture significantly increased elbow extension ROM in patients with rheumatoid arthritis.

Catalytic effect of zeolite LTA on thermal degradation of polysulfone and kinetic analysis

AbstractThermal stability of polysulfone (PSF) and its zeolite LTA hybrids with two different zeolite contents has been investigated by using differential thermal analysis (DTA) and thermogravimetric (TG) analysis measurements, and the thermal experiments in air were conducted at a constant heating rate in the span of 5–30 K/min. The thermal characteristics were evaluated based on TG and DTA results. Two‐stage thermal decomposition is seen to mainly occur in the range of 700–970 K and the zeolite LTA added has considerably influenced the thermal behavior of PSF. Two isoconversional model‐free Flynn–Wall–Ozawa and Coats–Redfern methods are employed to perform kinetic analysis of the mass loss versus temperature data, resulting in activation energy and pre exponential factor values. The activation energies obtained over the whole conversion range for two zeolite composites are considerably lower than those of pure PSF, possibly related to the catalytic effect of zeolite LTA added. The materials conversion functions D5 and D3 are found to more appropriately describe thermal degradation of PSF and its zeolite LTA hybrids. Using the kinetic parameters and conversion functions, the temperature‐dependent thermal conversion curves under different heating rates have been successfully recast, leading to excellent calculation results.

Role of Automated Red Cell Exchange in Acute and Chronic Complications of Sickle Cell Disease

Background. Automated red cell exchange transfusion (ARCET) is commonly used in patients with sickle cell disease, but objective data on its impact on acute and chronic complications are limited.Methods. Fifty-two sickle cell disease patients at the University of Illinois at Chicago underwent exchange transfusion from January 2011 to January 2016. Six patients were excluded due to incomplete data leaving 46 patients available for analysis. We collected data from the year before, year after and the year of ARCET to study the impact of red cell exchange on clinical, biological and hematological parameters.Results. There were 435 procedures with average of 9.45 per patient (range 4-14). The mean age of our cohort was 58.2 years. There were 22 (47.8%) males and 24 (52.2%) females. Genotypes include 42 (91.3%) HbSS, 1 (2.2%) HbSC, 1 (2.2%) HbSBeta+thalassemia and 2 (4.3%) HbSBeta0thalassemia. The most common indication for ARCET in our cohort was prior stroke in 32 patients (69.6%) and prevention of stroke in 7 patients (15.2%), followed by frequent vaso-occlusive crisis (VOC) 8 patients (17.4%), multiple acute chest syndrome 6 patients (13%), pulmonary hypertension 6 patients (13%) and chronic kidney disease 5 patients (8.9%). Iron overload, sickle hepatopathy, cardiomyopathy and seizure were some of the other indications. Twenty-five patients (54.3%) had more than one indication to undergo the ARCET. Thirty-one patients (67.4%) are still continuing the treatment. Thirty patients (65.2%) were on hydroxyurea (HU) prior to ARCET and 8 patients (17.4%) were still on HU while on ARCET. The mean frequency of ARCET was every 6 weeks. The mean pre and post ARCET values for hemoglobin(Hb), hematocrit (Hct), Hemoglobin S %(HbS), white cell count (wbc) and platelets(plt) are shown in Table 1. Paired t-test and Wilcoxon signed-rank test were used to analyze the clinical and hematological parameters. Analysis shows increase in mean Hb and Hct post ARCET and decrease in mean wbc, plt and HbS % post ARCET and the difference is statistically significant. (Table 3). Post ARCET body mass index (BMI) and weight are increased and the difference is statistically significant with p value 0.002 for BMI and 0.003 for weight. (Table 3). Ten (21.7%) patients showed decrease in the ferritin level post exchange. Thirty patients (65%) had VORTEX port whereas 29 patients (63%) had central venous access for procedures prior to Vortex placement (17/29, 59%). Nine patients (20%) had peripheral access mostly power port (for access) with one peripheral vein for return (6/9 67%). There were 10 access related complications and there were 3 port replacements due to septum damage and infection. There were 10 procedure related complications and 10 transfusion reactions as described in Table 2. ED admissions were decreased in 13(28.3%) patients from mean 7.69 to 2.92 admissions. The annual inpatient admissions showed a decrease in 18(39.2%) patients from mean 4.6 days pre ARCET to 1.6 admissions post ARCET. The acute care admissions showed an increase due to program expansion of our acute care center during this study period.Discussion. Our study shows that red cell exchange is an effective treatment modality for patients with sickle cell disease. It contributes to improvement in weight, increase in Hb and Hct and decrease in wbc, plt, HbS% and iron overload. It also decreases inpatient and ED admissions. The procedure is safe and tolerable with minimal complications. Long term studies are needed study the efficacy of this treatment modality and its contribution to improvement of quality of life and life expectancy in sickle cell disease patients. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Effect of Vitamin A on Lung Function Test in patient with Chronic Bronchial Asthma

In chronic bronchial asthma inflammation may be accompanied by intensive air flow limitation. Endogenous oxidants produced by overactive inflammatory cells destroy airway epithelium which slough into bronchial lumen and thus aggravates asthma. When oxidant overwhelm anti-oxidants, tissue injury and disease results. It is observed that decrease level of anti-oxidants in the lungs is a feature of chronic bronchial asthma and that there is a marked decrease of these levels during acute asthmatic attacks. These observations highlight the positive correlation between anti-oxidant therapy in asthmatic patients. The study was carried out to observe the changes in lung function in patients with chronic bronchial asthma both before and after supplementation of anti-oxidant vitamin A. Pulmonary function variables such as FVE, FEV1, FEV1/FVC%and PEFR were measured by spirometer in patients with chronic bronchial asthma both before and three month after supplementation of vitamin A 10,000 I.U orally daily. The mean FVC, FEV1, FEV1/FVC% and PEFR following vitamin A was unchanged significantly (P&lt;0.001) than the pre supplementation values in patients with chronic bronchial asthma. This study reveals that no improvement of pulmonary functions occur after supplementation of anti-oxidant vitamin A in chronic bronchial asthma patients.TAJ 2014; 27(1): 10-13

The effect of therapeutic abdominal drawing-in maneuver using ultrasonography on lateral abdominal muscle thickness and balance.

Lateral abdominal muscles control the lumbar region and this manages the stability of the trunk through co-contraction. Abdominal drawing-in maneuver (ADIM) is the basis method for spine stabilization to restore proper neuromuscular control. To investigate the effect of therapeutic abdominal drawing-in maneuver on abdominal muscle thickness and balance. Twenty healthy adults were divided into 2 groups. The experimental group performed a bridging exercise with ADIM whereas the control group performed a bridging exercise without ADIM. The exercise was conducted 3 times a week for 4 weeks. Ultrasonography was used to measure the thickness of abdominal muscles. Balance ability was evaluated using Tetrax device. The Wilcoxon signed ranks test for comparison of pre and post values and Mann Whitney U test for comparison between groups were used. After 4 weeks, there was a significant difference in the thickness of TrA between groups (p< 0.05) whereas no significant difference in IO and EO (p> 0.05). In stability values, the experimental group showed significant changes in stability indexes of standing with eyes open (NO) and standing on the pillow with eyes closed (PC) after the exercise period and there was a significant difference in NO between two groups. Performing the bridging exercise with abdominal drawing-in maneuver is a more effective way to strengthen the abdominal muscles and stabilize the body than bridging exercise only.

Comparison of Pre-Event VHR Optical Data and Post-Event PolSAR Data to Investigate Damage Caused by the 2011 Japan Tsunami in Built-Up Areas

Combining pre-disaster optical and post-disaster synthetic aperture radar (SAR) satellite data is essential for the timely damage investigation because the availability of data in a disaster area is usually limited. This article proposes a novel method to assess damage in urban areas by analyzing combined pre-disaster very high resolution (VHR) optical data and post-disaster polarimetric SAR (PolSAR) data, which has rarely been used in previous research because the two data have extremely different characteristics. To overcome these differences and effectively compare VHR optical data and PolSAR data, a technique to simulate polarization orientation angles (POAs) in built-up areas was developed using building orientations extracted from VHR optical data. The POA is an intrinsic parameter of PolSAR data and has a physical relationship with building orientation. A damage level indicator was also proposed, based on the consideration of diminished homogeneity of POA values by damaged buildings. The indicator is the difference between directional dispersions of the pre and post-disaster POA values. Damage assessment in urban areas was conducted by using the indicator calculated with the simulated pre-disaster POAs from VHR optical data and the derived post-disaster PolSAR POAs. The proposed method was validated on the case study of the 2011 tsunami in Japan using pre-disaster KOMPSAT-2 data and post-disaster ALOS/PALSAR-1 data. The experimental results demonstrated that the proposed method accurately simulated the POAs with a root mean square error (RMSE) value of 2.761° and successfully measured the level of damage in built-up areas. The proposed method can facilitate efficient and fast damage assessment in built-up areas by comparing pre-disaster VHR optical data and post-disaster PolSAR data.

COMPARATIVE STUDY OF MULLIGAN (SNAGS) AND MAITLAND MOBILIZATION IN NECK PAIN

Objectives: Comparative Study of Mulligan (SNAGs) and Maitland’s Mobilization in Neck Pain. Design: Randomized Control Trial. Methodology: A total of 50 patients were included as per pre define inclusion and exclusion criteria and randomly assigned into two groups each having 25 patients. Group A was given conventional therapy (Active, Isometrics exercises, moist hot packs) plus SNAG while Group B was given conventional therapy (Active, Isometrics exercises, moist hot packs) plus Maitland’s mobilization for 4 weeks, 3 sessions per week one session per day. The patient’s outcome measures were assessed by visual analog scale, NDI (Neck disability Index) and Goniometry for Cervical Range of Motion. Pre and post treatment values were recorded for comparison of results. Results: Results revealed that means and S.D of both group were clinically significant but statically the Group of patients treated with conventional therapy plus SNAGS managed pain (pre=4.25±1.6, post=2.35±0.3), NDI (pre= 15.81±2.5, post= 8.18±1.7) and range of motion (flexion pre=48.9±8.9, post=53.9±4.9, extension pre=55±4.1, post=63.9±3.1, Rt side flexion pre=38.5±2.1, post=43.1±2.0 and lt. side flexion pre=38.5±2.1, post=43.6±1.8, Rt side rotation pre= 61.7±6.3, post=65.7±5.5) lt. side rotation pre=60.5±3.01, post=67.6±3.5) is not better than group of patient treated with conventional therapy plus Maitland’s mobilization in terms of pain (pre=4.27±1.5, post=1.73±0.19), NDI (pre=17.1±3.31, post=8.10±1.10) and range of motion (flexion pre=48.5±4.7, post=56.7±6.5,extension pre=57.1±4.8, post=67.9±3.9, Rt side flexion pre=35.6±2.9 post=43.1±2.2, lt Side flexion pre=38.1±2.1, post=42.5±2.0, Rt side rotation pre=58.5±5.5 post=67.1.±5.4, lt Side rotation pre=59.6±5.6, post=67.7±4.3. Conclusion: The result of study suggests that both SNAG and Maitland’s improves the symptoms of Neck pain. Better improvement was shown by Maitland’s group than SNAGs group. Based on these results Maitland mobilization with conventional therapy should be the treatment of choice for Neck pain rather than SNAGs with conventional therapy. Article visualizations:

Short-Term Effects of Rolling Massage on Energy Cost of Running and Power of the Lower Limbs.

Self-myofascial release (SMFR) is a type of self-massage that is becoming popular among athletes. However, SMFR's effects on running performance have not yet been investigated. The aim of this study was to evaluate the effects of SMFR on the cost of running (Cr). In addition, the authors evaluated the effects of SMFR on lower-limb muscle power. Cr and lower-limb muscle power during squat jump (SJ) and countermovement jump (CMJ) were measured before (PRE), immediately after (POST), and 3 h after (POST 3h) an SMFR protocol (experimental condition). In the control-condition testing session, the same measurements were performed without undergoing the SMFR protocol. Experimental and control conditions were tested in a randomized order. Cr at POST trended to increase compared with PRE (+6.2% [8.3%], P = .052), whereas at POST 3h, Cr was restored to PRE values (+0.28% [9.5%], P = .950). In the experimental condition, no significant effect of time was observed for maximal power exerted during SJ. By contrast, maximal power exerted during CMJ at POST and at POST 3h was significantly higher than that observed at PRE (+7.9% [6.3%], P = .002 and +10.0% [8.7%], P = .004, respectively). The rate of force development measured during CMJ also increased after SMFR, reaching statistical significance at 200 ms from force onset at POST 3h (+38.9%, P = .024). An acute use of foam rollers for SMFR performed immediately prior to running may negatively affect endurance running performance, but its use should be added before explosive motor performances that include stretch-shortening cycles.

Study of correlation of ER, PR, HER2 receptor status in breast cancer at a single tertiary care hospital with emphasis on clinical utility of PR receptor

Background: The receptor status of breast cancer, including ER, PR and HER 2, play a crucial role in the development of treatment plan of breast cancer. Clinical utility of ER as a predictive biomarker to identify patients likely to benefit from hormonal therapy is well established, added value of PR is less defined. This study aim to know the demography of breast cancer and to document the status of ER, PR and HER 2 status in the north Indian population, as catered by single tertiary care hospital in Lucknow, Uttar Pradesh.Methods: All the patients of breast cancers where surgery or core biopsy was performed for invasive breast carcinoma followed by evaluation of ER, PR and HER 2 status were included in the study from January 2014 to June 2018. Cases were analyzed retrospectively for documentation of ER, PR and HER2 status, using American society of Clinical Oncology/College of American Pathologists (ASCO/CAP) interpretation guidelines.Results: 112 patients were included in the study with mean age of 53.70±12.47. Most common histological type was invasive carcinoma of no special type. 43.75% cases were ER+/PR+, 5.35% were ER+/PR-, and 50.89% were ER-/PR-. ER-/PR+ status was seen in none of our cases. Correlation of ER and PR with HER 2 was possible in 90 cases and triple negative breast cancer (TNBC) status was observed in 32.2% of cases.Conclusions: Demography and ER positivity and incidence of TNBC is not different from rest of India, however the clinical utility for evaluation of PR receptor is to be further investigated.

Influence of Training Load on Mood Disturbance at Sea Level and 3900 m Altitude: A Case Study of a Wheelchair Athlete

The purpose of this case study was to investigate the influence of a training load (TL), oxygen saturation (SO2) and blood pressure (BP) on mood states in a wheelchair marathoner during (7 weeks at sea level (SL), 5 weeks at 3860 m altitude, 1 week returning to SL). TL was obtained with Foster’s equation while mood states were obtained with the Profile of Mood States Questionnaire (POMS). Furthermore, SO2 and BP were assessed upon wakening. SO2 (%) decreased at altitude, compared to SL (88.31 ± 2.46 vs. 98.52 ± 0.11) and increased until the last week at altitude (92.64 ± 1.12). Systolic pressure (SP) increased at altitude compared to pre-altitude (126.0 ± 5.1 vs. 107.6 ± 4.4 mmhg), and was not different from the last week at altitude. Controlling for SO2 and SP, differences were also observed in fatigue (97.66 ± 18.92 vs. 17.39 ± 13.71) and vigor (73.23 ± 8.62 vs. 26.48 ± 11.89) as a function of altitude. Upon return to SL, fatigue, vigor, SO2 and SP returned to pre values. This case study demonstrated the POMS was sensitive to worsening patterns in fatigue and vigor at altitude through a practical survey approach combined with daily physiological assessment.

Yoga practice to improve sleep quality and body composition parameters of obese male - a randomized controlled trial.

Background Globally obesity increase is a big challenge. Obesity causes many non-communicable diseases. Options to control obesity are in search. Aim: To assess the outcome of 3 months follow-up period, after 14 weeks yoga intervention, for body composition and sleep quality parameters on obese male in urban setting. Materials and methods Design: Parallel group RCT (randomized controlled trial) on obese male. The two groups were yoga and control groups, with yoga (n = 37, age 40.03 ± 8.74), control (n = 35, age 42.20 ± 12.06). The IAYT (integrated approach of yoga therapy) training was given to yoga group for 14 weeks, and the unsupervised yoga practice was continued by the subjects at their home, for further 3 months. Training was 1.5 hour daily for 5 days in a week, which included the IAYT module of Suryanamaskara Asana Pranayama and relaxation. No yoga activity but walking etc. for the same time, was given to control group. Body composition parameters were assessed through BIA (bioelectrical impedance) method using InBody R 20 model. The sleep quality was assessed using PSQI (Pittsburgh sleep quality index). Within group and between group analysis were performed, using SPSS version 21. The correlation analysis was carried out on the difference in pre follow-up values. Results During the follow-up period within the group, the body composition parameters improved and the parameters of quality of sleep showed trends of improvement. Also some of the gain obtained during 14 weeks intervention was lost during follow-up period. Conclusions The changes observed may indicate the long-term benefits of yoga practice for control of obesity in urban setting for males.

Pleural thickness after neoadjuvant chemotherapy is a prognostic factor in malignant pleural mesothelioma

ObjectivesDefinitive diagnosis of the T-component is sometimes challenging in malignant pleural mesothelioma (MPM). Pleural thickness has been reported to be a prognostic factor for MPM and is a potential T-component. MethodsWe conducted a historical cohort study of patients who underwent neoadjuvant chemotherapy (NAC) and curative-intent surgery as a multimodal treatment for MPM from January 2007 to June 2016. The maximum measurement of pleural thickness among 3 levels and the sum at each level determined using axial computed tomography imaging before and after NAC were termed as “max” and “sum,” respectively. We assessed the association between pleural thickness and the primary and secondary end points of overall survival and recurrence-free survival. Survival was analyzed using the Kaplan–Meier curve, log rank test, and multivariate Cox regression model. ResultsWe enrolled 105 patients. We excluded 1 because of missing data; thus, the sample size was 104. The median follow-up period was 29.1 months with recurrence in 78 patients (70.3%) and death in 67 (60.4%). Max and sum ranged from pre (before NAC) values of 0 to 35 (median, 6.05) and 0 to 97 (median, 12.9) to post (after NAC) values of 0 to 30.8 (median, 4.25) and 0 to 67.0 (median, 9.25), respectively. Post values max and sum were associated with overall survival and recurrence-free survival. Post sum values were associated with recurrence (adjusted hazard ratio, 2.59; 95% confidence interval, 1.42-3.83) and death (adjusted hazard ratio, 2.13; 95% confidence interval, 1.16-4.52), respectively. ConclusionsPleural thickness after NAC was an independent prognostic factor in patients who underwent multimodal treatment.

Could Nasal Surgery Affect Multilevel Surgery Results for Obstructive Sleep Apnea?

To study the role of nasal surgery as a part of multilevel surgery for management of obstructive sleep apnea (OSA). All patients underwent multilevel surgery for relieving OSA symptoms and they were classified according to type of surgical intervention into: group A (20 patients), who underwent hyoid suspension (Hyoidthyroidpexy), tonsillectomy, suspension (El-Ahl and El-Anwar) sutures and nasal surgery (inferior turbinate surgery). Group B (20 patients), who underwent hyoid suspension (Hyoidthyroidpexy), tonsillectomy and suspension sutures. Pre and postoperative sleep study, Epworth sleepiness scale, snoring score were reported and compared. Apnea hypoapnea index (AHI) dropped significantly in both groups. The mean preoperative AHI was significantly less in patients who had no nasal obstruction (P = 0.0367), while the difference in postoperative values was nonsignificant (P = 0.7358).The mean Epworth sleepiness scale improved significantly in both groups, but the difference between pre and postoperative values in both groups was nonsignificant. The lowest oxygen saturation elevated significantly in both groups, but the difference between pre and postoperative values in both groups was nonsignificant. As regards snoring scores, they dropped significantly in both groups. The preoperative snoring score was reported to be significantly more in patients who had associated nasal obstruction (group A) (P = 0.0113). But after surgery the difference in postoperative values was nonsignificant (P = 0.1296). Treatment of nasal obstruction should be considered a crucial component in the comprehensive management plan for OSA patients as it has significant impact on the patients' AHI and snoring.

P2.16-20 Prognostic Utility of PET in Non-Small Cell Lung Cancer After Empiric Stereotactic Body Radiotherapy (SBRT)

Positron emission tomography (PET-CT) is valuable for diagnosing early stage non-small cell lung cancer (NSCLC) in the absence of biopsy. Here we investigate the diagnostic, prognostic, and treatment response of PET-CT in NSCLC treated with empiric stereotactic body radiotherapy (SBRT). We retrospectively reviewed 78 empiric lung SBRT cases with pre-treatment PET scans treated to biologic equivalent dose≥100 Gy10. We correlated pre and post-treatment standard uptake values (SUV) with local, regional, and distant control. Statistical analysis was conducted via SPSS v20. A total of 44 males and 34 females median age 77 were treated to 48 Gy in 4 fractions (n=47) or 50 Gy in 5 fractions (n=31). Lung nodules were 1.6 cm (0.6–4.5 cm) with a median planning target volume of 19.1 cc (3.7-97.4 cc). Median pre-treatment SUV=4.1 (0-20). Of the 43 patients with post-treatment PETs, median SUV = 2.7(0-7.2) or 53%(0-302%) of the pretreatment SUV. The median follow-up was 18 months with a 3-year survival of 50% for all patients. Local, regional, and distant control rates at 3 years were 91%, 81%, and 78%, respectively. Relative sisease control for pre-treatment SUV ≤4.0 compared to >4.0 is shown in Table 1: There was no difference in tumor size, location, nodule morphology, or prior cancer/smoking history between patients with pre-treatment SUV ≤ 4 (n=40) and > 4 (n=38). Receiver operating characteristic curve analysis identified optimal SUV cutoff values of 6.0, 3.5, and 4.0 to predict local, regional, and distant failure, respectively. Post-SBRT PET scans with SUV reduction ≥50% demonstrated a 2-year freedom from progression of 89% compared to 57% with SUV reduction <50% (P=0.08). Our study demonstrates a strong correlation between initial PET avidity and regional/distant recurrence, and a trend with local recurrence. Perhaps patients with pretreatment SUV>4 warrant a mediastinal evaluation or closer vigilance in follow-up, though this warrants prospective investigation.

Effects of repeated social mixing on behavior and blood immune cells of group-housed pregnant sows (Sus scrofa domestica)

Commercial housing of sows often involves frequent regrouping (“mixing”) of animals that poses a potential welfare problem due to social stress. Although mixing is a common management practice worldwide, immunological consequences are poorly investigated in pregnant sows. This study combines both behavioral and endocrine data with detailed analyses of blood cellular immunity to examine whether repeated social mixing affects the immune system in pregnant sows, which none of the studies conducted so far could confirm. Pregnant multiparous sows (German Landrace, n = 40) were housed in groups of five animals. Sows were either assigned to a repeated social mixing treatment with a mutual exchange of two randomly selected sows of two specific groups (2 × 2) twice a week over a period of eight weeks, or remained undisturbed in their original group. Blood samples of all sows were collected at five time points before, during, and after the mixing period to evaluate the distribution of blood lymphocyte subpopulations, mitogen-induced lymphocyte proliferation and plasma cortisol concentrations. Mixing caused higher levels of aggressive behavior (p ≤ 0.05) during the entire mixing period. Compared to pre mixing baseline values, lymphocyte numbers were lower in mixed sows (p ≤ 0.05), which was primarily caused by lower antigen-experienced T helper cells, cytotoxic T cells and natural killer cells. Mixed sows showed a higher proliferative response of lymphocytes while granulocytes and cortisol concentrations were not affected (p > 0.05). Repeated social mixing thus not only resulted in an increase of aggressive behavior, but also in altered immune cell numbers of the adaptive immune system, even though sows became eventually familiar with each other. These findings suggest, in contrast to previous studies, an adverse influence of frequent mixing on the immune system of pregnant sows.

Effect of Inspiratory Muscle Training on Performance of Handball Athletes.

Inspiratory muscle training (IMT) is a strategy that has been used to improve performance in different sports modalities. This study investigated the effects of an IMT program on respiratory muscle strength and resistance as well as aerobic physical performance (PP) of handball athletes. Nineteen 20 ± 3 year-old male athletes were allocated into an experimental (EG, n = 10) or a placebo group (PG, n = 9). Their respiratory muscle strength was evaluated by measuring the maximum inspiratory and expiratory pressures (MIP and MEP), muscular respiratory resistance by maximum voluntary ventilation (MVV) and aerobic PP by the cardiopulmonary exercise test. The study was designed to evaluate the effects of a 12-week IMT program with five sessions a week. A significant difference was observed in the pre and post IMT values of the MIP (170 ± 34 to 262 ± 33 cmH2O) and MEP (177 ± 36 to 218 ± 37 cmH2O) in the EG, and MIP (173 ± 45 to 213 ± 21 cmH2O) in the PG, with a large effect size for the MIP, when the groups were compared. MVV showed a significant increase (162 ± 24 to 173 ± 30 L) in the EG, with a small effect size. There was a significant difference in maximum oxygen uptake (54 ± 8 to 60 ± 7 ml/kg/min) in aerobic PP. Oxygen uptake at the respiratory compensation point (RCP) (46 ± 6 to 50 ± 5 ml/kg/min), with a moderate effect size for both variables, was observed in the EG after IMT. We concluded that IMT provided a significant increase in respiratory muscle strength and resistance, contributing to increased aerobic PP in the EG, which suggests that IMT could be incorporated in handball players’ training.

Cambios en índice de masa corporal en pacientes portadores de apnea del sueño a un año de tratamiento con dispositivo de presión de aire positiva continua (CPAP)

Sleep Apnea Syndrome (SAS) it is highly related to obesity. The main purpose of this study is to determine the variation between Apnea Hypopnea Index (AHI) and Body Mass Index (BMI) on sleep apnea patients after a year of CPAP treatment on the Linde Sleep Center. Results: 104 male patients were included in this study, the variables analyzed were; AHI, BMI, Epworth daytime somnolence. As for the data obtained from BMI, after one year of treatment with CPAP, the BMI showed a significant decrease (p < 0.001). In the daytime sleepiness scale, a significant decrease was also found between pre and post treatment values. Discussion: Evidence has consistently suggested that higher body weight would also have higher levels of AHI, and the improvements in BMI referred to in this study emphasize the importance of proper treatment not only in control of respiratory events, but in the reduction of body weight.