Mild Degree Research Articles

Atrial fibrillation in patients with obstructive sleep apnea (retrospective study)

Introduction. Atrial fibrillation (AF) and obstructive sleep apnea (OSA) are common in the population and share common risk factors. The prevalence of OSA in AF is established, but the incidence of AF in patients with OSA is not studied.Purpose. To study the incidence of atrial fibrillation and atrial remodeling in patients with varying severity of obstructive sleep apnea syndrome.Materials and methods. Retrospective analysis of 216 medical records of patients hospitalized in a therapeutic hospital in whom screening respiratory monitoring revealed OSA.Results. Atrial fibrillation was diagnosed in 62/216 patients (28,7 %) with OSA. AF was more often observed in patients with severe OSA – in 27/76 (35,5 %) compared to those examined with a mild degree – 16/78 (20,5 %) (p=0,043). Permanent AF was more common in severe OSA compared to mild OSA (48,2 % and 10,5 %; p<0,01). The left atrial volume index (LAVI) in patients with paroxysmal AF in combination with severe OSA is greater than in patients with AF and mild and moderate OSA (58,4±11,3; 40,8±8,1 and 41,9±7,7; p<0,01). The right atrium volume index (RAVI) in patients with paroxysmal AF in combination with severe OSA is greater than in patients with AF and mild and moderate OSA (42,8±11,0; 30,2±2,2 and 32,7±8,4; p<0,05).Conclusion. Atrial fibrillation in patients with obstructive sleep apnea syndrome is more common than in the general population, and the combination of paroxysmal atrial fibrillation with severe sleep disordered breathing characterized by more pronounced atrial remodeling than when arrhythmia is combined with mild to moderate sleep apnea.

Development of huge keloid at donor site and recurrent keloid at graft site after excision of pubic keloid followed by split-thickness skin graft: A case report.

Keloids are the result of abnormal tissue scarring that occur after skin injuries leading to pain, psychological distress, and impaired quality of life. Despite the high recurrence rate after surgical treatment, excision is often inevitable for symptom control. A 32-year-old female presented with a huge keloid on the pubic area accompanied by severe pain, pruritus, and infectious discharge. She also had multiple keloids on her chest and shoulders, indicating a strong predisposition to keloid formation. While high potential for recurrence was anticipated, surgical excision was inevitable for symptom control. Complete keloid excision followed by split-thickness skin graft was performed. Pathological report revealed keloid accompanied by ruptured epidermal inclusion cyst. Although postoperative care was highly recommended for prevention of keloid recurrence, the patient refused any additional management due to her financial difficulties. At postoperative 8 months, mild degree of keloid or hypertrophic scar at marginal area of the graft was observed, suggesting the potential sign of keloid recurrence. The patient voluntarily discontinued the outpatient follow-up for 2 years, and then returned with huge keloid not only at the graft site but also at the donor site. Keloid with inflamed epidermal inclusion cyst can cause severe pain where surgical excision is unavoidable, regardless of the high potential for recurrence. Additional postoperative care is necessary to prevent recurrence. Furthermore, attempts to minimize new keloid formation at the donor site after split-thickness skin graft, such as thin skin harvest or selecting the scalp as the donor site, should be considered.

Efficacy and safety of tetrandrine in treatment of rheumatoid arthritis: a meta-analysis.

To explore the efficacy and safety of tetrandrine in the treatment of rheumatoid arthritis. Randomized controlled studies of tetrandrine in the treatment of rheumatoid arthritis were searched in CNKI, VIP, Wanfang database, SinoMed, PubMed, Springer, Web of Science and Cochrane Central Register of Controlled Trails databases. A meta-analysis was conducted using R 3.5.3 software to evaluate the clinical outcomes, including the total effective rate, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), visual analogue scale (VAS), disease activity score (DAS), tender joint count (TJC), swollen joint count (SJC), and morning stiffness duration, as well as adverse events of rheumatoid arthritis patients. A total of 10 articles were included in the study. The meta-analysis indicated that tetrandrine significantly improved the total effective rate (OR=3.27, 95%CI: 2.01-5.37, P<0.01), ESR (SMD=1.12, 95%CI: 0.06-2.19, P<0.05), CRP (SMD=0.75, 95%CI: 0.28-1.22, P<0.01), VAS (SMD=0.64, 95%CI: 0.29-1.00, P<0.01), TJC (SMD=1.16, 95%CI: 0.58-1.74, P<0.01), SJC (SMD=0.85, 95%CI: 0.40-1.31, P<0.01), and morning stiffness (SMD=1.09, 95%CI: 0.68-1.50, P<0.01). However, no statistical significance was found in RF (SMD=1.70, 95%CI: －1.10-4.51, P>0.05) and DAS (SMD=0.26, 95%CI: －0.59-1.11, P>0.05). The overall incidence of adverse events associated with tetrandrine treatment for rheumatoid arthritis was 20% (95%CI: 12%-27%, I2=60%, P<0.05), with mild severity and favorable outcomes. Tetrandrine is effective in the treatment of RA patients with a mild degree of adverse events.

Significant Relationship Between Brixia Score And The Degree Of Acute Respiratory Distress Syndrome In Covid 19 Patients

BACKGROUND: Chest X-ray has an important role in detecting early features of COVID-19. To improve risk stratification, a scoring system in chest x-ray called Brixia Score was developed. The Brixia score is designed to measure the severity of lung abnormalities in COVID-19, with an 18-point severity scale. Deaths in COVID-19 occur mainly due to Acute Respiratory Distress Syndrome (ARDS). ARDS is classified into mild, moderate, and severe degrees. If the degree can be predicted earlier, patients can receive earlier therapy and death rate can be reduced. AIMS: to analyze relationship between Brixia Score and degree of ARDS in COVID-19 patients. METHOD: the research used an observational analytic method with a cross-sectional approach to 95 subjects who are positive for COVID-19 and diagnosed with ARDS, in January to December 2021. Brixia Score data was collected based on chest X-ray expertise, ARDS degree was based on medical records and blood gas analysis. Analysis of relationship between Brixia score and degree of ARDS was carried out using the Kruskal-Wallis test. RESULT: There was a significant difference in Brixia score based on degree of ARDS (p value &lt;0.05). The highest Brixia score was obtained in severe ARDS, while the low Brixia score was obtained in mild ARDS. This proves that there is a relationship between Brixia score and degree of ARDS. CONCLUSION: Brixia score has a significant relationship to the degree of ARDS in COVID-19 patients.

Association Between Postoperative Decrease of Albumin and Outcomes in Patients Undergoing Craniotomy for Brain Tumors

Serum albumin reflects nutritional status and is associated with postoperative complications and mortality. Delta albumin (ΔAlb), defined as the difference between preoperative and lowest postoperative levels, could predict complications and mortality, even with postoperative levels above 30g/L prompting albumin infusions. This study aimed to assess how ΔAlb relates to outcomes in craniotomy patients with brain tumors. This retrospective study screened patients diagnosed with a brain tumor who underwent cerebral surgery from a single Chinese hospital between December 2010 and April 2021. Patients were divided into 4 groups based on their ΔAlb levels: <5g/L (normal), 5-9.9g/L (mild ΔAlb), 10-14.9g/L (moderate ΔAlb), and ≥15g/L (severe ΔAlb). The primary outcome was postoperative 30-day mortality. Among the 9660 patients undergoing craniotomy for brain tumors, the median ΔAlb level after craniotomy was 7.3g/L. ΔAlb was associated with increased postoperative 30-day mortality; odds ratios for mild, moderate, and severe ΔAlb were 1.93 (95% confidence interval [CI], 1.17-3.18, P= 0.01), 2.21 (95% CI, 1.28-3.79, P= 0.004), and 7.26 (95% CI, 4.19-12.58, P<0.01), respectively. Significantly, ΔAlb >5g/L was found to have a strong association with a higher risk of mortality, even when the nadir Alb remained greater than 30g/L (odds ratio, 1.84; 95% CI, 1.13-3.00, P= 0.014). Among patients undergoing craniotomy for brain tumor resection, a mild degree of ΔAlb was associated with increased 30-day mortality, even if the nadir Alb remained greater than 30g/L. Moreover, ΔAlb was associated with postoperative complications and longer lengths of stay.

Alpha and theta oscillations on a visual strategic processing task in age-related hearing loss.

Emerging evidence suggests changes in several cognitive control processes in individuals with age-related hearing loss (ARHL). However, value-directed strategic processing, which involves selectively processing salient information based on high value, has been relatively unexplored in ARHL. Our previous work has shown behavioral changes in strategic processing in individuals with ARHL. The current study examined event-related alpha and theta oscillations linked to a visual, value-directed strategic processing task in 19 individuals with mild untreated ARHL and 17 normal hearing controls of comparable age and education. Five unique word lists were presented where words were assigned high- or low-value based on the letter case, and electroencephalography (EEG) data was recorded during task performance. The main effect of the group was observed in early time periods. Specifically, greater theta synchronization was seen in the ARHL group relative to the control group. Interaction between group and value was observed at later time points, with greater theta synchronization for high- versus low-value information in those with ARHL. Our findings provide evidence for oscillatory changes tied to a visual task of value-directed strategic processing in individuals with mild untreated ARHL. This points towards modality-independent neurophysiological changes in cognitive control in individuals with mild degrees of ARHL and adds to the rapidly growing literature on the cognitive consequences of ARHL.

Functional Mobility Scale and Scoliosis Degree before and after Zoledronate Therapy in Children with Osteogenesis Imperfecta

Abstract Background Intravenous zoledronate, has been indicated for the treatment of Osteogenesis imperfecta (OI). It is a heritable disorder that causes bone fragility. The purpose of this study was to evaluate its effect on functional mobility scale and scoliosis degree on children with OI. Methods and Results This observational study was conducted on 28 OI patients (12 boys &amp; 16 girls) aged 1.3-7.15years. All parameters were evaluated at Pediatric Endocrinology clinic, Children’s Hospital, Ain Shams University. Treatment was started with zoledronate dose 0.05 mg/kg every 6 months. Children less than 3 years of age received intravenous Zoledronate at a dose of 0.025 mg/kg per dose every 6 months with a maximum dose of 2 mg, while children above 3 years old received 0.05 mg/kg/dose every 6 months with a maximum dose of 4 mg. FMS and scoliosis degree using cobb anglewere evaluated before and after zoledronate therapy. Patients showed highly significant improvement in FMS. Patients with mild and moderate degree of scoliosis showed a non significant improvement in the degree of scoliosis while patients with severe scoliosis didn’t show any statistically significant difference. Conclusion Our study showed that intravenous zoledronate treatment, given once every 6 months, is an effective mode of treatment in OI children. It was associated with improvement in FMS. Longer follow-up is necessary to monitor the effect of treatment on degree of scoliosis by cobb angle.

The difference in IL-17 level between mild and severe COVID-19 inpatients of H. Adam Malik General Hospital

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by a new coronavirus, Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2). Pro-inflammatory cytokines play a central role in many viral respiratory infections by coordinating and activating adaptive immune responses. Higher serum levels of pro-inflammatory cytokines (TNF-α, IL-1β, IL-2, IL-6 and IL-17) and chemokines (IL-8) have been observed in many patients with severe COVID-19 compared with individuals with a mild degree. This research is an observational study with cross sectional data collection method. This study took blood samples from mild and severe COVID-19 patients who were treated at the HAM Hospital as many as 34 patients. Samples were examined only once for IL-17 in mild and severe COVID-19 patients. The research was conducted after obtaining ethical approval and informed consent. This study was followed by 18 female subjects (52.9%). The mean age of the subjects was 47.52 years with the youngest age being 23 years old and the oldest being 81 years old. By using the Mann Whitney test, it showed that there was a significant difference in interleukin 17 levels between Covid-19 patients with severe and mild degrees (p = 0.049). IL-17 examination can be used as an alternative diagnostic marker and assess the severity in COVID 19 patients. Further studies are needed that involve a larger number of subjects, and are associated with other inflammatory markers such as CRP or with coagulation status such as D- dimer.

Incidence Rates of Pediculosis Capitis and Helminthiasis in Children in Danukusuman Surakarta

Pediculosis capitis and helminthiasis It is categorized as a neglected disease but is still an important health problem, especially for children. These two diseases each cause clinical disorders on the surface and internal organs of the body. Danukusuman is one of the most densely populated areas in the city of Surakarta, where in previous years many cases of gastrointestinal disorders affected local residents. The aim of this study to determine the incidence of pediculosis capitis and helminthiasis in elementary school children in the city of Surakarta. This research uses a descriptive analysis research design. The population in the study were children aged 6-8 years in Danukusuman Surakarta totaling 100 respondents. Samples were taken using total sampling technique. The diagnosis of pediculosis capitis is made on the skin and hair area of the head and intensity helminth enforced use method Kato katz from fecal samples by calculating the number of worm parasite eggs per gram of feces (EPG). Based on research conducted on 100 respondents, the results showed that 29 (29%) respondents had pediculosis capitis and cases of helminthiasis showed that 2 respondents (2%) had Ascari lumbricoides and Trichuris trichiura with a total of 24 epg of parasites each with a light infection intensity. From the results of this study, it was reported that the incidence of pediculosis capitis in children in Danukusuman was 29% and helminth infections were 2% of cases with a mild degree of infection.

The impact of instrumented lumbar fusion surgery on psychiatric problems in elderly patients with degenerative spinal stenosis: The observational study.

This is a prospective cohort study to investigate the effects of instrumented lumbar fusion surgery on psychiatric problems, including anxiety, insomnia, and depression, in patients with degenerative spinal stenosis, as well as on pain and the activities of daily living. Surgery was performed in the patients with Schizas grade C or D spinal stenosis with; if a patient's quality of life was impaired for at least 3 months or if patient had neurologic deficits. Finally, 69 patients were reviewed. Beck anxiety inventory, insomnia severity index, geriatric depression scale short form-Korean, visual analog scale for back pain, visual analog scale for leg pain, and Oswestry disability index was measured on the day surgery was decided on (T1), the day before surgery (T2), the day before discharge (T3), and 6 months after surgery (T4). The patients had mild degrees of anxiety, insomnia, and depression at T1, and Beck anxiety inventory, insomnia severity index, visual analog scale for back pain, visual analog scale for leg pain, and Oswestry disability index improved significantly by T4. In elderly patients with degenerative spinal stenosis, instrumented lumbar fusion surgery improves not only pain and activities of daily living, but also anxiety and insomnia. However, there was no improvement in depression over the 6-month follow-up period.

Layer-specific enhancement of visual-evoked activity in the audiovisual cortex following a mild degree of hearing loss in adult rats

Following adult-onset hearing impairment, crossmodal plasticity can occur within various sensory cortices, often characterized by increased neural responses to visual stimulation in not only the auditory cortex, but also in the visual and audiovisual cortices. In the present study, we used an established model of loud noise exposure in rats to examine, for the first time, whether the crossmodal plasticity in the audiovisual cortex that occurs following a relatively mild degree of hearing loss emerges solely from altered intracortical processing or if thalamocortical changes also contribute to the crossmodal effects. Using a combination of an established pharmacological ‘cortical silencing’ protocol and current source density analysis of the laminar activity recorded across the layers of the audiovisual cortex (i.e., the lateral extrastriate visual cortex, V2L), we observed layer-specific changes post-silencing in the strength of the residual visual, but not auditory, input in the noise exposed rats with mild hearing loss compared to rats with normal hearing. Furthermore, based on a comparison of the laminar profiles pre- versus post-silencing in both groups, we can conclude that noise exposure caused a re-allocation of the strength of visual inputs across the layers of the V2L cortex, including enhanced visual-evoked activity in the granular layer; findings consistent with thalamocortical plasticity. Finally, we confirmed that audiovisual integration within the V2L cortex depends on intact processing within intracortical circuits, and that this form of multisensory processing is vulnerable to disruption by noise-induced hearing loss. Ultimately, the present study furthers our understanding of the contribution of intracortical and thalamocortical processing to crossmodal plasticity as well as to audiovisual integration under both normal and mildly-impaired hearing conditions.

Вміст пластидних пігментів у дерев сосни звичайної уражених сосновим вертуном в умовах Західного Полісся

The biosynthesis of plastid pigments in Pinus sylvestrys L.was investigated in pine trees affected by Melampsora pinitorqua in the conditions of the Western Polissya. The total content of chlorophylls and carotenoids in the needles of trees with a mild and moderate degree of damage by Melampsora pinitorqua is 13,3…30,0% lower than in the control. Trees severely affected by Melampsora pinitorqua synthesize 21.8...38.4% less green and yellow pigments. A decrease in the content of green pigments in experimental pine trees is caused by chlorophyll a. Іt influences on absorption direct sunlight for the process of photosynthesis. The ratio of chlorophylls a/b is close to the control in experimental trees with a mild and moderate degree of disease damage and decreases by 23.3...32.9% in trees with a severe degree of disease damage. Іn all affected trees, the ratio between the amount of green and yellow pigments is close to the control.

The Clinical Impact of Paravalvular Leaks With Transcutaneous Aortic Valve Implantation (TAVI) Versus Surgical Aortic Valve Replacement (SAVR): A Systematic Review and Meta-Analysis

Aortic valve stenosis is a common cardiac condition that requires intervention for symptomatic and/or prognostic reasons. The two most common interventions are surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI). The ratio of TAVI:SAVR has increased twofold over the past few years and is now being considered in intermediate-risk patients as well. One of the significant benefits of TAVI is that it is less invasive; however, one of the drawbacks is a high paravalvular leaks (PVLs) rate compared to SAVR. To assess the impact of PVLs on survival, progression of heart failure, and the need for re-intervention. We conducted a comprehensive systematic literature search from the conception of TAVI 2002 until December 2022 through Embase (Ovid), MEDLINE (Ovid), Science Direct, and CENTRAL (Wiley). We followed PRISMA guidelines and checklists. Review protocol registration ID in PROSPERO: CRD42023393742. We identified 28 studies that met our eligibility criteria, and only 24 studies were suitable for pooling in a meta-analysis (including their hazard ratio with a confidence interval of 95%) assessing our primary outcome (all-cause mortality). The remaining four studies were narratively synthesised. RevMan V5.4 (Version 5.4. Cochrane Collaboration, 2020) was utilised to pool meta-analysis data to assess effect estimates of PVLs in both intervention arms, using a random effect model for calculation (hazard ratio 1.14 confidence interval 95% 1.08-1.21 [p<0.0001]), with a follow-up duration between 30 days to 5 years. Patients with mild or higher degrees of PVLs in both intervention arms incurred unfavourable outcomes. The incidence of PVLs was significantly higher with TAVI; even a mild degree led to poor quality of life and increased all-cause mortality on long-term follow-up.

Clinical Observation on Haploid Hematopoietic Stem Cells Combined with Umbilical Cord Blood Double Transplantation for Aplastic Anaemia in Children

To explore the efficacy and safety of haploidentical hematopoietic stem cell transplantation combined with umbilical cord blood infusion for the treatment of aplastic anaemia in children. Nine cases of children with aplastic anaemia treated with umbilical cord blood combined with haploidentical hematopoietic stem cell transplantation at the People's Hospital of Henan University of Chinese Medicine from January 1, 2021 to September 15, 2023 with a median age of 11(2-13) years and a median follow up of 18(7.5-21) months were included, and the clinical data were retrospectively analyzed. Hematopoiesis reconstitution, the incidence of graft-versus-host disease(GVHD), infections and survival of the patients were analyzed. All 9 children were successfully implanted. The median time to neutrophil and platelet implantation was 11.11±1.27 d and 12.44±3.36 d, respectively. One case developed acute gastrointestinal GVHD of degree I, which was improved after treatment, and the patient developed superficial gastritis and chronic gastrointestinal GVHD at a later stage, which is currently under clinical follow-up. Acute GVHD of II-IV degree was 0%. Hemorrhagic cystitis in 3 cases, CMV infection in 5 cases and bacterial and fungal infections in 5 cases improved with symptomatic treatment.All 9 children demonstrated complete donor chimerism within 1 month after transplantation, at two years of follow-up, all nine children survived without recurrence or development of grade II-IV GVHD, and there were no children with transplant-related deaths. Haploidentical hematopoietic stem cell transplantation combined with umbilical cord blood transfusion for aplastic anaemia in children has a low incidence and mild degree of GVHD, with significant efficacy, and can be used as a therapeutic option for children without an HLA full donor chimeric match.

#1986 Incidence of renal anemia among patients with atrial fibrillation and chronic kidney disease stage IIIb-V

Abstract Background and Aims According to the QICKD study, the prevalence of anemia in stage IIIb-V chronic kidney disease (CKD) is 22%. The incidence of renal anemia ranges from 8.4% in patients with stage I CKD to 83.7% in patients with stage V CKD. In patients on program hemodialysis, anemia develops in 94.5% of cases. The problem is associated with an increased risk of unfavorable outcome of CKD, therefore, the study of aspects of anemia among patients receiving anticoagulant therapy with atrial fibrillation (AF) and CKD remains the most relevant today. The purpose of the study is to study the prevalence of renal anemia among patients with AF and CKD stages IIIb-V. Method 794 patients were admitted to the cardiology department with a diagnosis of AF and late stages of CKD—IIIb (glomerular filtration rate (GFR) 45–30 ml/min/1.73 m2), IV (GFR 29–15 ml/min/1.73 m2), V (GFR &amp;lt;15 ml/min/1.73 m2), for the first identified sustained decrease in glomerular filtration rate (FISD in GFR) of less than 45 ml/min/1.73 m2. The classification of renal anemia was carried out according to the recommendations of the World Health Organization. Results Renal anemia was diagnosed in 505 (63%) patients with AF and GFR less than 45 ml/min/1.73 m2. In total, among patients with CKD stage IIIb, anemia was detected in 207 (59%) patients, with CKD stage IV—in 110 (89%), with CKD stage V—in 43 (97%), with FISD in GFR—in 145 (51%). A mild degree of anemia (hemoglobin (Hb) in men 110-129 g/l, in women 110-119 g/l) was diagnosed in 39% of patients, with CKD stage IIIb in 85 (24%) patients, with CKD stage IV in 28 (22%) patients, with CKD stage V in 9 (20%) patients, with FISD in GFR in 75 (26%) patients. A moderate degree of anemia (Hb 81-109 g/l) was detected in 47.3% of cases, with CKD stage IIIb in 86 (25%) patients, with CKD stage IV in 60 (48%) patients, with CKD stage V in 29 (66%) patients, with FISD in GFR in 64 (23%) patients. Severe anemia (Hb 81-109 g/l) was detected in 47.3% of patients, with CKD stage IIIb in 36 (10%) patients, with CKD stage IV in 22 (19%) patients, with CKD stage V in 5 (11%) patients, with FISD in GFR in 6 (2%) patients. Conclusion Every fourth patient in the cardiology department with AF and GFR &amp;lt;45 ml/min/1.73 m2 was diagnosed with renal anemia, and its prevalence increases with a decrease in GFR. The above results indicate that a more careful selection of anticoagulant therapy is recommended for this patient population due to the high risk of progression of renal anemia in this cohort of patients.

#1066 Unobvious long-term effects of COVID-19 for kidneys

Abstract Background and Aims The impact of COVID-19 on the chronic kidney disease (CKD) has already been confirmed by researchers around the world. However, there is still no description of this infection influence on kidney function without signs of CKD before it. Method The study included 359 patients from the Moscow region who applied to the nephrologist of the first level regional center in 2022, 154 men and 205 women, mean age 59±16 years. Among the patients who applied for the past year, there were 70 patients with a previously confirmed diagnosis of CKD and 289 who first applied to a nephrologist and had no nephrology complaints, clinical or laboratory signs of CKD before. Results A total of 95 patients from both groups had COVID-19 in 2020-2022 before a visit to a nephrologist, 45 people from the group with CKD (47.4%) and 50 people (52.6%) who were not diagnosed with CKD before COVID-19. 20.4% had COVID-19 earlier than 2 months ago, 6.4% - from 2 to 6 months ago, 45.3% - from 6 to 12 months ago, 27.9% from 12 to 24 months ago. A mild degree of COVID-19 was in 49.4% of patients, moderate - 43, 3%, heavy - 7.3%. It is important to note that 48 patients (96%) who first contacted a nephrologist after COVID-19 were diagnosed with CKD (CKD stages 1-2 - 14 patients (29.17%), 3A and 3B stages - 24 patients (50%), 4 and 5 stages - 10 patients (20.83%)). Relative risk of stage 3+ CKD after COVID-19: RR= 1.036 [95% CI 0.8961 to 1.170], p=0.6742, relative risk of stage 5 CKD: RR= 0.7164 [95% CI 0.3259 to 1.534], p= 0.5403. Thus, the development of advanced (3+) stages of CKD cannot be directly related to past COVID-19. However, if we consider the risk of developing advanced stages of CKD for patients who have experienced moderate to severe COVID-19, then the relative risk of stage 3+ CKD: RR= 1.082 [95% CI 0.8936 to 1.236], p= 0.4607, and relative risk of stage 5 CKD RR = 1.013 [95% CI 0.4134 to 2.341], p&amp;gt;0.9999. Conclusion Unfortunately, it is not possible to link the risk of developing CKD in patients after COVID-19 with the timing after COVID-19 at this stage of the study. In addition, the relationship between COVID-19 and CKD stage cannot be assessed without taking about the structure of CKD causes in both groups. Obviously, a larger and deeper study of this issue is needed, possibly with more patients and long-term monitoring of the dynamics of renal function in patients of both groups.

#328 Non-invasive assessment of urinary exfoliated proximal tubule cells using multispectral autofluorescence imaging features for early detection of CKD

Abstract Background and Aims Early detection of CKD is important to allow for timely intervention which may reduce adverse clinical outcomes and cost of renal replacement therapies. Histopathological diagnosis of CKD remains the gold standard, but routine kidney biopsy is costly and associated with risks such as pain and bleeding. There is a need to develop accurate non-invasive methods for early diagnosis and prognostication of CKD. Kidney cell exfoliation into urine is an active process, which may generate significant information regarding an individual's kidney status. In particular, proximal tubule cells (PTCs) make up majority of the kidney mass and represents the hallmark of CKD in reflecting the degree of tubulointerstitial fibrosis and atrophy. Multispectral assessment of native cell autofluorescence has been specifically shown to be sensitive to metabolic changes and oxidative stress, which are key factors involved in kidney function decline. Hence, we evaluated whether multispectral autofluorescence signals in urinary exfoliated PTCs reflect kidney function as determined by eGFR. Method Individuals aged 18 or above were included and informed consent was obtained from all participants involved in this study. Spot urine samples were collected and stored at -80°C. On assessment, exfoliated PTCs were extracted from thawed urine using a validated specific immunomagnetic separation method based on anti-CD13 and anti-SGLT2 antibodies. Multispectral autofluorescence imaging was performed using a custom-made autofluorescence microscopy system (standard Olympus iX83™ fluorescence microscope and multispectral excitation lamp from Quantitative™, AU). Images were captured by a Nüvü™ EMCCD camera HNü 1024 cooled to -65°C in our laboratory to reduce sensor-induced noise. For the 34 image channels taken per sample, image acquisition times of up to 5 seconds per channel, with multiple averaging (3 times) was applied to optimize image quality. Image analysis was conducted through a workflow encompassing data preprocessing, data normalization and outlier handling, followed by basic model training and evaluation. An entropy-based image feature selection methodology was initially completed by hand, with results subsequently compared to that generated from the AutoGluon machine-learning framework [1]. The models developed from this process were assessed using ROC (Receiver Operating Characteristic) curves and AUC (Area Under the Curve) values. Two discriminative studies were performed – an overall study between exfoliated PTCs of individuals eGFR≥60 and eGFR &amp;lt; 60 ml/min/1.73 m2 and a subgroup study between that of individuals eGFR≥90 and eGFR 60-90 ml/min/1.73 m2. Results 40 individuals were included in our study. 20 individuals had eGFR≥60 and 20 had eGFR &amp;lt; 60 ml/min/1.73 m2. Multispectral assessment of cell autofluorescence features differentiated between exfoliated PTCs of these 2 groups with AUC value of 0.97 (95% CI 0.94-1.00) (Fig. 1), model accuracy being 82%. Subgroup analysis included 20 individuals of which 10 had eGFR≥90 and 10 had eGFR 60-90 ml/min/1.73 m2. Multispectral assessment of cell autofluorescence features differentiated between exfoliated PTCs of these 2 groups with AUC value of 0.99 (95% CI 0.99-1.00) (Fig. 2), model accuracy being 85%. Conclusion An excellent degree of differentiation between urinary PTCs derived from those with normal or high eGFR and mild degrees of CKD is now reliably demonstrated, complementing conclusions from our group's original small pilot study which evaluated between urinary PTCs from CKD and non-CKD cohorts [2]. Further studies are required to determine whether our novel method can be used to non-invasively predict individuals at risk of progressive kidney disease and to monitor whether intervention is effective.

The relationship of limited mobility of the cervical spinewith postural and mental reactions of students

Introduction: Previous studies have found that, in addition to the general factors for the occurrence of pain and reduced mobility of the cervical spine, the use of electronic devices promotes these, the excessive use of which can also lead to the occurrence of depressive symptoms in students. The aim of this study was to determine the mobility limitation of the cervical spine in students with reported neck pain, to determine the degree of disability and depression due to neck pain, to determine the correlation of mobility limitation of the cervical spine with the degree of disability and depression of students, and to determine the correlation of the degree of disability with the degree of depression. Methods: The research was conducted as a cross-sectional study from May to July 2021 at the University of Zenica in four faculties. The study used the General Questionnaire and two standardized questionnaires to assess disability due to neck pain (Index of Disability due to Neck Pain) and the degree of depression (patient health questionnaire). Results: A total of 147 students with reported neck pain participated in the study. A limitation of mobility was found in 30.6% of the students in flexion, 25.2% in rotation, 23.8% in lateral flexion, and 20.4% on extension. Mild disability due to neck pain was found in 58.5% of students, moderate in 23.8%, and severe in 2.7%. 45.6% of the students had mild depression, 18.4% had moderate depression, and 5.4% had severe depression.Conclusion: Restricted flexion and rotation are more common than restricted lateral flexion and extension of the cervical spine. About half of the students who reported neck pain had a mild degree of disability and mild depression. A strong positive correlation was found between the degree of disability and depression in students with neck pain.

TESTING LIMITED OVERLAP

Extreme propensity scores arise in observational studies when treated and control units have very different characteristics. This is commonly referred to as limited overlap. In this paper, we propose a formal statistical test that helps assess the degree of limited overlap. Rejecting the null hypothesis in our test indicates either no or very mild degree of limited overlap and hence reassures that standard treatment effect estimators will be well behaved. One distinguishing feature of our test is that it only requires the use of a few extreme propensity scores, which is in stark contrast to other methods that require consistent estimates of some tail index. Without the need to extrapolate using observations far away from the tail, our procedure is expected to exhibit excellent size properties, a result that is also borne out in our simulation study.

Correlation of serum interleukin-8 levels and prostate volume to the degree of lower urinary tract symptoms in patients with benign prostate enlargement: a cross-sectional study

BackgroundBenign prostatic enlargement (BPE) and lower urinary tract symptoms (LUTS) are pro-inflammatory cytokine interleukin-8 (IL-8)-associated which causes epithelial hyperplasia of the prostate transitional zone. This study aimed to determine the correlation between the levels of IL-8 serum and the prostate volume with the degree of LUTS severity in patients with BPE.MethodsDetermination of the correlation between serum IL-8 levels and prostate volume with the LUTS severity degree was conducted using a cross-sectional approach. The International Prostate Symptom Score was used to measure the LUTS severity degree, the enzyme-linked immunosorbent assay (ELISA) technique was used to measure the serum IL-8 level, and the transabdominal ultrasonography (TAUS) was used to measure the prostate volume. The sample used in this study was 32 patients with BPE grouped by the degree of LUTS severity of the patients. The correlation between variables was then analyzed using the Pearson correlation test.ResultsThe prostate volume was higher in severe LUTS degree (38.19 cc) than in the mild LUTS degree (13.05 cc). The levels of serum IL-8 were higher in the severe LUTS degree (21.65 pg/mL) than in the mild LUTS degree (8.44 pg/m). Both the levels of serum IL-8 and the degree of LUTS did not have a significant correlation with the volume of prostate (p > 0.05). On the other side, the prostate volume and the degree of LUTS severity had a significant positive correlation (p = 0.001, R = 0.913).ConclusionThe prostate volume and the levels of serum IL-8 are higher in the severe LUTS degree. There is a trend of increasing prostate volume with the severity of LUTS symptoms and higher serum IL-8 levels. The severity of prostate enlargement can be assessed by measuring the levels of IL-8 in the serum.