Profile Of Patients Research Articles

Examination of drug removal profiles in patients undergoing therapeutic plasma exchange: A retrospective study.

Therapeutic plasma exchange (TPE) eliminates disease-contributing substances but may also affect drug concentrations. This study aimed to assess the prevalence of prescription drugs removable via TPE by reviewing patient medication histories. A retrospective, single-center study was conducted from January 1, 2021 to December 31, 2022. The study included 244 patients undergoing 1087 TPE sessions. Drugs prescribed to patients on TPE days were categorized as "yes" (probably removable), "maybe" (possibly removable), and "no" (unlikely removable) regarding their removability via TPE. Among 3966 prescriptions, 556 (14.0%) were analyzed, with 21.8%, 36.5%, and 41.7% falling into the "yes," "maybe," and "no" categories for removability. Although only 14.0% were categorized, 83.6% of patients received at least one analyzable drug. Among them, 83.8% had at least one potentially removable drug. Real-world data highlights the need for caution in drug treatments during TPE to ensure optimal therapeutic outcomes, particularly for specific drugs.

Adverse drug events associated with fluorouracil use in patients with metastatic colorectal cancer: a real-world pharmacovigilance study based on the FDA adverse event reporting system.

Fluorouracil (5-FU) is widely used to treat metastatic colorectal cancer (mCRC), but real-world safety data is limited. Our study aimed to evaluate 5-FU's safety profile in a large mCRC population using the FAERS database. We conducted disproportionality analyses to identify adverse drug events associated with 5-FU use in mCRC patients from 2004 to 2023. Subgroup analyses, gender difference analyses, and logistic regression were also performed. We identified 1,458 reports with 5-FU as the primary suspected drug, with males accounting for 48.8% of reports. Gastrointestinal disorders were the most common adverse event (864 cases), while pregnancy-related conditions showed the strongest signal intensity (ROR = 2.97). We found 19 preferred terms with positive signals, including ischemic hepatitis (ROR = 59.32), blood iron increased (ROR = 59.32), and stress cardiomyopathy (ROR = 51.94). Males were more susceptible to weight loss and skin toxicity. Most adverse events occurred within the first month of 5-FU administration. Our study provides a comprehensive analysis of 5-FU's safety profile in mCRC patients, helping healthcare professionals mitigate risks in clinical practice.

Metabolomics and network pharmacology exploration of the effects of bile acids on carotid atherosclerosis and potential underlying mechanisms

BackgroundBile acids (BAs), products of gut microbiota metabolism, have long been implicated in atherosclerotic disease pathogenesis. Characterizing the serum bile acid profile and exploring its potential role in carotid atherosclerosis (CAS) development are crucial tasks.MethodsIn this study, we recruited 73 patients with CAS as the disease group and 77 healthy individuals as the control group. We systematically measured the serum concentrations of 15 bile acids using ultrahigh-performance liquid chromatography-mass spectrometry (UPLC-MS/MS). Multivariate logistic regression and least absolute shrinkage and selection operator (LASSO) regression were applied to analyze the impact of bile acids on the disease and select the key BAs. The possible molecular mechanism was elucidated by network pharmacology.Results(1) The BA profile of patients with CAS significantly differed. (2) Multifactorial logistic regression analysis identified elevated levels of GCDCA (OR: 1.01, P < 0.001), DCA (OR: 1.01, P = 0.005), and TDCA (OR: 1.05, P = 0.002) as independent risk factors for CAS development. Conversely, GCA (OR: 0.99, P = 0.020), LCA (OR: 0.83, P = 0.002), and GUDCA (OR: 0.99, P = 0.003) were associated with protective effects against the disease. GCA, DCA, LCA, and TDCA were identified as the four key BAs. (3) TNF, FXR, GPBAR1, ESR1 and ACE were predicted to be targets of BAs against AS. These four BAs potentially impact AS progression by triggering signaling pathways, including cAMP, PPAR, and PI3K-AKT pathways, via their targets.ConclusionThis study offers valuable insights into potential therapeutic strategies for atherosclerosis that target bile acids.

Emotional intelligence and neurocognition profiles in first-episode psychosis: A two-year follow-up study

Emotional intelligence (EI) and neurocognition (NC) impairments are common in first-episode psychosis (FEP), yet their evolution over time remains unclear. This study identified patient profiles in EI and NC performance in FEP. 98 adult FEP patients and 128 healthy controls (HCs) were tested on clinical, functional, EI, and NC variables at baseline and two-year follow-up (FUP). A repeated-measures ANOVA compared the effects of group (patients and HCs) and time on EI. Significant EI improvements were observed in both groups. Four groups were created based on NC and EI performance at baseline and FUP in patients: impairment in NC and EI, impairment in NC only, impairment in EI only, and no impairment. At FUP, patients impaired in NC and EI showed less cognitive reserve (CR), greater negative and positive symptoms, and poorer functional outcomes. At FUP, three group trajectories were identified: (I) maintain dual impairment (II) maintain no impairment or improve, (III) maintain sole impairment or worsen. The maintain dual impairment group had the lowest levels of CR. EI and NC impairments progress differently in FEP. Greater CR may protect against comorbid EI/NC impairment. Identifying these patient characteristics could contribute to the development of personalised interventions.

Genetics of 67 patients of suspected primary ciliary dyskinesia from India.

Data are limited on the genetic profile of primary ciliary dyskinesia (PCD) from developing countries. Here, we report one of the first study on genetic profile of patients with suspected PCD from India. In this prospective cross-sectional study, we enrolled 162 children with suspected PCD. We recorded clinical features, relevant laboratory tests for PCD and performed whole exome sequencing (WES). We are reporting 67 patients here who had positive variant/s on WES. We had 117 variants in 40 genes among 67 patients. Among the 108 unique variants, 33 were categorized as pathogenic or likely pathogenic (P/LP). We had nine novel variants in out cohort. The 29 definite PCD cases, diagnosed by composite reference standards, had variants in 16 genes namely LRRC6/DNAAF11 (5), DNAH5 (3), CCDC39 (3), HYDIN (3), DNAH11 (2), CCDC40 (2), CCDC65 (2) and one each DNAAF3, DNAAF2, CFAP300, RPGR, CCDC103, CCDC114, SPAG1, DNAI1, and DNAH14. To conclude, we identified 108 unique variants in 40 genes among 67 patients. The common genes involved in definite cases of PCD in Indian patients were LRRC6, DNAH5, CCDC39, and HYDIN. Our findings suggest a need to develop a separate genetic panel for PCD in the Indian population.

The Effect of Mobile Lifestyle Intervention Combined with High-Protein Meal Replacement on Liver Function in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease: A Pilot Randomized Controlled Trial

While many studies have explored dietary substitutes and mobile apps separately, a combined approach to metabolic dysfunction-associated steatotic liver disease (MASLD) has not been investigated. This study evaluated short-term mobile interventions coupled with partial meal replacement in patients with MASLD. Sixty adults with MASLD and a body mass index ≥25 kg/m2 from a health examination center were randomized into an intervention group using a mobile app with partial meal replacements or a control group receiving standard educational materials. Liver enzyme levels, lipid profiles, and anthropometric measurements were assessed at baseline and after 4 weeks. Twenty-five participants in the intervention group and 24 in the control group completed the trial. Significant reductions were observed in the intervention group for alanine aminotransferase (−28.32 versus [vs.] −10.67, p = 0.006) and gamma-glutamyl transferase (−27.76 vs. 2.79, p = 0.014). No significant changes in aspartate aminotransferase, body weight, or waist circumference were noted in the intervention group. Four weeks of mobile lifestyle intervention incorporating partial meal replacements improved liver enzyme profiles in patients with MASLD. This strategy demonstrated the potential for mitigating elevated liver enzyme levels without altering body weight or waist circumference. Comprehensive and longer-term research is needed to substantiate and elaborate these preliminary outcomes.

High-intensity interval training improves bone remodeling, lipid profile, and physical function in multiple sclerosis patients

Multiple sclerosis (MS) is a demyelinating and neurodegenerative disease due to an autoimmune chronic inflammatory response, yet the etiology is currently not completely understood. It is already known that physical activity plays an essential role in improving quality of life, especially in neuropathological conditions. The study was aimed to investigate the possible benefits of high-intensity interval training (HIIT) in bone and lipid metabolism markers, and neuromotor abilities in MS patients. 130 participants were recruited; 16 subjects with MS met the inclusion criteria and were included in the data analysis. The patients were randomly assigned to two groups: a Control group (CG) (34.88 ± 4.45 yrs) that didn’t perform any physical activity and the Exercise group (EG) (36.20 ± 7.80 yrs) that performed HIIT protocol. The training program was conducted remotely by a kinesiologist. It was performed three times a week for 8 weeks. At the beginning (T0) and the end of the study (T1) physical function tests, bone remodelling markers, and lipid markers analyses were performed. After 8 weeks of training the wall squat (s) (T0 = 27.18 ± 4.21; T1 = 41.68 ± 5.38, p ≤ 0.01) and Time Up and Go test (s) (T0 = 7.65 ± 0.43; T1 = 6.34 ± 0.38 p ≤ 0.01) performances improved; lipid markers analysis showed a decrease in Total (mg/dl) (T0 = 187.22 ± 15.73; T1 = 173.44 ± 13.03, p ≤ 0.05) and LDL (mg/dl) (T0 = 108 ± 21.08; T1 = 95.02 ± 17.99, p < 0.05) cholesterol levels. Additionally, the levels of osteocalcin (µg/L), a marker of bone formation increased (T0 = 20.88 ± 4.22; T1 = 23.66 ± 6.24, p < 0.05), 25-OH Vitamin D (µg/L) improved after 8 weeks (T0 = 21.11 ± 7.11; T1 = 27.66 ± 7.59, p < 0.05). HIIT had an effect on lower limb strength and gait control, improved bone formation, and lipid management, in MS patients.

The electroretinography to identify biomarkers of idiopathic hypersomnia and narcolepsy type 1.

Hypersomnia spectrum disorders are underdiagnosed and poorly treated due to their heterogeneity and absence of biomarkers. The electroretinography has been proposed as a proxy of central dysfunction and has proved to be valuable to differentiate certain psychiatric disorders. Hypersomnolence is a shared core feature in central hypersomnia and psychiatric disorders. We therefore aimed to identify biomarkers by studying the electroretinography profile in patients with narcolepsy type 1, idiopathic hypersomnia and in controls. Cone, rod and retinal ganglion cells electrical activity were recorded with flash-electroretinography in non-dilated eye of 31 patients with idiopathic hypersomnia (women 84%, 26.6 ± 5.9 years), 19 patients with narcolepsy type 1 (women 63%, 36.6 ± 12.7 years) and 43 controls (women 58%, 30.6 ± 9.3 years). Reduced cone a-wave amplitude (p = 0.039) and prolonged cone (p = 0.022) and rod b-wave (p = 0.009) latencies were observed in patients with narcolepsy type 1 as compared with controls, while prolonged photopic negative response-wave latency (retinal ganglion cells activity) was observed in patients with idiopathic hypersomnia as compared with controls (p = 0.033). The rod and cone b-wave latency clearly distinguished narcolepsy type 1 from idiopathic hypersomnia and controls (area under the curve > 0.70), and the photopic negative response-wave latency distinguished idiopathic hypersomnia and narcolepsy type 1 from controls with an area under the curve > 0.68. This first original study shows electroretinography anomalies observed in patients with hypersomnia. Narcolepsy type 1 is associated with impaired cone and rod responses, whereas idiopathic hypersomnia is associated with impaired retinal ganglion cells response, suggesting different phototransduction alterations in both hypersomnias. Although these results need to be confirmed with a larger sample size, the electroretinography may be a promising tool for clinicians to differentiate hypersomnia subtypes.

How to integrate surgery and targeted therapy with biologics for the treatment of hidradenitis suppurativa: Delphi consensus statements from an Italian expert panel.

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by recurrent and painful nodules and abscesses in intertriginous skin areas, which can progress to sinus tract formation, tissue destruction, and scarring. HS is highly debilitating and severely impairs the psychological well-being and quality of life of patients. The therapeutic approach to HS is based on medical therapy and surgery. First-line medical therapy includes topical antibiotics, systemic antibiotics, and biologics. Main surgical procedures include deroofing, local excision, and wide local excision. Despite the availability of multiple therapeutic options, the rates of disease recurrence and progression continue to be high. In recent years, the possibility of combining biologic therapy and surgery has raised considerable interest. In a clinical trial, the perioperative use of adalimumab has been associated with greater response rates and improved inflammatory load and pain, with no increased risk of postoperative infectious complications. However, several practical aspects of combined biologic therapy and surgery are poorly defined. In June 2022, nine Italian HS experts convened to address issues related to the integration of biologic therapy and surgery in clinical practice. To this purpose, the experts identified ten areas of interest based on published evidence and personal experience: 1) patient profiling (diagnostic criteria, disease severity classification, assessment of response to treatment, patient-reported outcomes, comorbidities); 2) tailoring surgery to HS characteristics; 3) wide local excision; 4) pre-surgery biologic treatment; 5) concomitant biologic and surgical treatments; 6) pre- and post-surgery management; 7) antibiotic systemic therapy; 8) biologic therapy after radical surgery; 9) management of adverse events to biologics; 10) management of postoperative infectious complications. Consensus between experts was reached using the Estimate-Talk-Estimate method (Delphi Method). The statements were subsequently presented to a panel of 27 HS experts from across Italy, and their agreement was assessed using the UCLA Appropriateness Method. This article presents and discusses the consensus statements.

Neurocognitive and clinical profile of male patients with substance use disorder in early remission phase with and without comorbid depression

Substance Use Disorder (SUD) represents one of the most frequent conditions worldwide which commonly coexists with major depressive disorder (MDD). This comorbidity (SUD + MDD) is one of the most prevalent with patients showing certain social and clinical characteristics that could lead to a worsening of their cognitive performance. However, despite these particularities, only a few studies have addressed the possible differences in cognitive performance between patients with SUD + MDD compared with those with SUD-only patients. Therefore, the aim of this study is to examine the clinical and cognitive profile of patients with SUD + MDD vs. SUD-only who are in early remission phase. For this purpose, 271 male patients underwent a clinical and neuropsychological assessment (SUD + MDD group: N = 101; SUD-only group: N = 170). Results indicated that SUD + MDD patients showed worse cognitive performance than SUD in visuospatial reasoning, verbal memory and learning, recognition, and processing speed even after a 3-month period of abstinence. Furthermore, these patients exhibited more self-reported prefrontal symptoms, as well as worse social and clinical conditions. This study indicates that the neurocognitive and clinical profile of patients with SUD + MDD could represent a risk since their characteristics have been associated with poorer recovery and prognosis. Our results could be helpful in clinical practice highlighting the need for cognitive remediation strategies in these populations, providing information that would allow the implementation of more appropriate treatments and preventive strategies.

T Cells Immune Imbalance Present in Patients With Multiple Intracranial Aneurysms.

Growing evidence suggests that systemic immune and inflammatory responses may play a critical role in the formation and development of aneurysms. Exploring the differences between single intracranial aneurysm (SIA) and multiple IAs (MIAs) could provide insights for targeted therapies. However, there is a lack of comprehensive and detailed characterization of changes in circulating immune cells in MIAs. Peripheral blood mononuclear cell (PBMC) samples from patients with SIA (n = 16) or MIAs (n = 6) were analyzed using high-dimensional mass cytometry to evaluate the frequency and phenotype of immune cell subtypes. A total of 25 cell clusters were identified, revealing that the immune signature of MIAs included cluster changes. Compared to patients with SIA, patients with MIAs exhibited immune dysfunction and regulatory imbalance in T-cell clusters. They also had reduced numbers of CD8+ T cells and their subgroups CD8+ Te and CD8+ Tem cells, as well as reduced numbers of the CD4+ T-cell subgroup CD27-CD4+ Tem cells. Furthermore, compared to SIA, MIAs were associated with enhanced T-cell immune activation, with elevated expression levels of CD3, CD25, CD27, CCR7, GP130, and interleukin 10. This study provides insights into the circulating immune cell profiles in patients with MIAs, highlighting the similarities and differences between patients with SIA and those with MIAs. Furthermore, the study suggests that circulating immune dysfunction may contribute to development of MIAs.

Using Kane’s Validity Theory to compare an Integrated and Single Skill Objective Structured Clinical Examination

The aim of this study was to compare the validity of an integrated Objective Structured Clinical Examination (OSCE) station assessing both oral and written components to an OSCE station assessing one single skill (oral only), both targeted at assessing taking a best possible medication history. A convergent mixed methods design that utilized the four inferences (scoring, generalization, extrapolation and implications) of Kane's Validity Framework as a scaffold to integrate qualitative data (post OSCE reflections) and quantitative data (assessment grades and categories of medication errors) was applied. In 2022, 216 students completed the OSCE station with the oral component alone whilst in 2023, 254 students completed the integrated (oral and written) OSCE station. Students in 2023 performed significantly better, with a median score of 88% versus 80% in 2022 (p=0.002). There was a greater proportion of commission errors in the integrated assessment (20.4% vs 15.3%), but less omission errors (29.9% vs 31.8%) and patient profile errors (5.1% vs 69.4%). Student reflections revealed rushed conversations in the integrated assessment with a greater focus on written formatting, but an appreciation for the authenticity and structured format of the integrated OSCE compared to the single skill OSCE alone. Students completing the integrated OSCE (with oral and written components) had less patient profile and medication omission errors than students who completed the oral only OSCE. Considering Kane's Validity Framework, there was a more positive argument for the more authentic integrated OSCE in the inferences of extrapolation and implications.

Cognitive profile of kidney transplant patients and impact of deceased vs. living donor transplantation.

It is important to learn more about the prevalence, severity and characteristics (i.e., which cognitive abilities are especially affected) of cognitive impairment in kidney transplant patients. Furthermore, the impact of living vs. deceased donor renal transplantation on cognitive outcome in this patient groupneeds further studies. Fifty-nine patients (43 men, age 55 ± 13years) who received a deceased donor or living donor kidney transplant, completed a comprehensive neuropsychological test assessment. Neuropsychological tests explored the cognitive domains of verbal and visual memory, attention, and executive functions. Fifteenpercent of the patients had mild, 25% moderate, and 15% severe cognitive impairment. The level of domain-specific cognitive deficit differed between verbal memory, attention, and executive functions (χ2(2) = 7.11, p = 0.029). On average, patients showed the highest deficit in executive functions, and the lowest deficit in verbal memory. Patients who received a kidney graft from a deceased donor were more likely to have a cognitive impairment than those who received a kidney graft from a living donor (OR = 3.03, 95% CI [0.99,9.32], Wald χ2(1) = 3.74, p = 0.053). This effect was independent of time on dialysis as well as of creatinine levels, or creatinine clearance. Our results show that in kidney transplant patients with cognitive impairment, the cognitive domain of executive functions is the most affected one. This might be detrimental for quality of life. The fact that patients who received living donor kidneys seem to do better in terms of cognition than patients with deceased donor kidneys deserves more attention in future research.

Why are continent catheterizable channels continent? A stomal pressure profilometry feasibility study.

A continent catheterizable channel (CCC) may be a solution for patients with impaired bladder emptying and difficult transurethral access. Leakage of the CCC is a common complication. To prevent leakage, the pressure in the CCC has to be higher than the reservoir (bladder/pouch) pressure in at least one location. It has not been clearly defined through which mechanism(s) the CCC achieves continence. In this feasibility study, we measured the CCC pressure profile in adult patients with various types of CCC's with and without stomal leakage. Adult patients with a CCC on a (augmented) bladder or pouch who underwent a urodynamic investigation between January and March 2023 were included. Next to the standard urodynamic investigation, a continuous stomal pressure measurement (CSP) and stomal pressure profilometry with empty bladder (SPP-1) and with filled bladder (SPP-2) of the CCC were performed. A total of 17 patients were included. It was technically possible to perform SPP-1 and SPP-2 in all patients, and to measure the CSP in 16/17 patients. The median maximum stomal pressures in SPP-1 and SPP-2 were 112 (interquartile range [IQR], 76-140) cmH2O and 120 (IQR, 92-140) cmH2O, respectively. Nine patients had stomal leakage during the urodynamic investigation. In five patients, the detrusor leak point pressure (dLPP) was low (<20 cmH2O). A pressure peak at the beginning of SPP-2 was absent in all patients with stomal leakage at low dLPP. SPP and CSP measurement in CCCs are feasible. We found differences in SPP-2 between patients with and without leakage at low dLPP, indicative of a role of the intravesical tunnel in continence or high dLPP. The results of this study may improve our understanding of the physiology and dynamics of CCCs as well as the management of CCC-related complications.

Clinical profile of patients with atrial fibrillation in an outpatient setting of a hospital in India: A cross-sectional study

Abstract Background: There has been an increasing trend of prevalence of atrial fibrillation (AF) globally. As per estimates, there is a possibility of doubling or tripling of AF cases by 2050. Early diagnosis by common symptom screening can help prevent complications in patients with AF. Objective: The objective of this study was to study the causes, symptoms, and complications of AF. Materials and Methods: A hospital-based cross-sectional study was carried out among 100 cases of AF who presented to the outpatient department for follow-up. History, thorough clinical examination, and investigations such as electrocardiogram (ECG) and echocardiogram were carried out for all cases. For all cases, 12-lead ECG was recorded. M-mode two-dimension echocardiography was done in all cases. Results: As age increased, the proportion of AF increased. The most important and leading cause of AF across all age groups and both sexes was rheumatic heart disease (RHD). There was a slight female preponderance. The most common valvular lesion in RHD was a combination of mitral stenosis and mitral regurgitation in 40%. The most common symptom was dyspnea (92%) followed by palpitations (84%). The most common complication was heart failure (40%) followed by left atrial clots (10%). Conclusion: RHD was the most common cause of AF. Mitral valve was affected in almost all cases. Dyspnea and palpitations were the most common presenting symptoms. Heart failure was the most common complication. Screening for AF in all cases with dyspnea and palpitations can help with early diagnosis and prompt treatment of AF and can prevent further complications.

Examining the association of physical activity and mortality among recently hospitalized older adults with dementia

IntroductionThis study aimed to examine the association between physical activity one month post discharge and mortality over the first-year post discharge among recently hospitalized older adults with dementia. MethodsFor this descriptive sub-study, among 42 participants, we obtained physical activity data via accelerometry at one month post discharge and death status via phone call at 6 months and 1 year post discharge. We performed logistic regression. ResultsWe found that participants’ amount of time spent in physical activity one month post hospital discharge was not statistically significantly associated with mortality within the first-year post hospital discharge (OR=.996, CI=.992,1.000; p=.053). However, we did observe a strong trend. ConclusionsGiven the small sample of participants, this trend is salient and should be examined in a larger sample. The results highlight a specific patient profile, recently hospitalized older adults with dementia, that would greatly benefit from physical activity interventions.

Blindness Detection – A Systematic Research

The proposed framework merges Generative Adversarial Networks (GANs) with Reinforcement Learning (RL) techniques to enhance blindness detection. GANs generate synthetic retinal images covering various eye diseases, enriching training data and improving generalization. RL optimizes screening strategies dynamically, adjusting decisions based on evolving patient profiles and environmental cues. Empirical evaluations on real-world datasets demonstrate superior performance over conventional methods, addressing data imbalance and fostering adaptable screening policies. This synergistic fusion offers a comprehensive, adaptable, and interpretable approach to early diagnosis and preventive care, highlighting the potential of advanced AI techniques in healthcare.

Prediction of Different Risk Factors in Relation to Hyperlipidemia Using Framingham Risk Score and Cholesterol Risk Score in a Tertiary Care Hospital.

A condition that affects the circulatory system of the human body is referred to as a cardiovascular disease (CVD). Cardiovascular diseases (CVDs) are responsible for a significant number of fatalities globally. Annually, CVDs result in the demise of 17.9 million people, which accounts for 31% of all fatalities on a global scale. The objective of the study was to assess the demographic profile of diabetic and nondiabetic patients suffering from cardiovascular disease. The aim of the study is to predict risk factors in relation to hyperlipidaemia using two different scales, the Framingham Risk Scale (FRS) and the Cholesterol Risk Calculator (CRC), and to determine the frequency of hypercholesterolemia in relation to CVD. A cross-sectional study was conducted in Guru Gobind Singh Medical College and Hospital, Punjab, India. The mean age of patients was found to be M= (51.23), SD= (9.348) years, and among 331 patients (52.6%) were female patients. The mean of Framingham Risk Score was found to be (29.07%). The Framingham Risk Score was found significant with gender and calorie intake below the recommended dietary allowances of the patient (p=0.001). The Framingham Risk Score was found significant with physical activity and employment status of the patients (p= 0.001). In linear regression, the Framingham Risk Score was found significant with the lipid profile of the patients (p=0.001) i.e., the higher the value of cholesterol level, the higher the Framingham Risk Score. The chi-square test showed a significant relation between Cholesterol Risk Score and employment status, physical activity, calorie intake, gender, and occupation of the patients (p=0.001, p=0.001, p=0.001, p=0.004) respectively. The present study demonstrated that patients with high Framingham risk score and cholesterol risk score are at increased risk of diabetes and cardiovascular disease. The present study concludes that the FRS is higher in patients below RDA, patients doing low physical activity, and sedentary workers. In order to provide proper assistance and counselling, healthcare professionals must continuously analyze each patient's risk factor for CVD and barriers to healthy and preventive behaviors. There is a lack of comprehensive studies comparing the effectiveness of the Framingham Risk Score and Cholesterol Risk Score in predicting hyperlipidemia and associated cardiovascular risks within the context of a tertiary care hospital setting.

Assessment of communicative competence in adult patients with minimum response in intensive care units: A scoping review.

Few formal instruments exist to assess the communicative competence of patients hospitalized in intensive care units (ICUs). This can limit interventions by health professionals. To map the categories and instruments for assessing the communicative competence of adult patients with minimal response in ICUs. A scoping review was carried out following the Joanna Briggs Institute protocol between February and March 2022 and using the MEDLINE (PubMed), Scopus, Scielo, Business Source Complete (via EBSCOhost), Academic Search Complete (via EBSCOhost) and Web of Science databases, in Portuguese, English and Spanish. Eight studies met the inclusion criteria. The different communication and pain assessment protocols covered awareness, cognition, sensory capacity, motor capacity, language, speech and literacy. The present review offers a starting point for the construction of a formal assessment instrument to enable clinicians to implement an augmentative or alternative communication system (AACS) for the voluntary, independent and active participation of patients. What is already known on the subject Patients in ICUs are subject to various forms of treatment and continuous and intensive monitoring, compromising their capacity to communicate and actively participate (e.g., sharing symptoms and making decisions). Although there is some awareness of their disadvantage in such a regard, few protocols of assessment of communicative competence have been adapted to patients with a minimum response. What this paper adds to the existing knowledge The present review highlights different protocols for the assessment of communication and pain. They include the following categories: awareness, sensory capacity, auditory and visual acuity, positioning and motor capacity, language, speech, and literacy. The review offers a starting point for the construction of a formal assessment instrument encompassing the aforementioned categories, along with duly validated guidelines for its application. What are the potential or actual clinical implications of this work? Our formal assessment instrument takes into account the need to adapt to different patient profiles. It is hoped that it will provide speech therapists and other health professionals with the information required to implement an AACS in which patients participate actively.

Assessment of communicative competence in adult patients with minimum response in intensive care units: A scoping review.

Few formal instruments exist to assess the communicative competence of patients hospitalized in intensive care units (ICUs). This can limit interventions by health professionals. To map the categories and instruments for assessing the communicative competence of adult patients with minimal response in ICUs. A scoping review was carried out following the Joanna Briggs Institute protocol between February and March 2022 and using the MEDLINE (PubMed), Scopus, Scielo, Business Source Complete (via EBSCOhost), Academic Search Complete (via EBSCOhost) and Web of Science databases, in Portuguese, English and Spanish. Eight studies met the inclusion criteria. The different communication and pain assessment protocols covered awareness, cognition, sensory capacity, motor capacity, language, speech and literacy. The present review offers a starting point for the construction of a formal assessment instrument to enable clinicians to implement an augmentative or alternative communication system (AACS) for the voluntary, independent and active participation of patients. What is already known on the subject Patients in ICUs are subject to various forms of treatment and continuous and intensive monitoring, compromising their capacity to communicate and actively participate (e.g., sharing symptoms and making decisions). Although there is some awareness of their disadvantage in such a regard, few protocols of assessment of communicative competence have been adapted to patients with a minimum response. What this paper adds to the existing knowledge The present review highlights different protocols for the assessment of communication and pain. They include the following categories: awareness, sensory capacity, auditory and visual acuity, positioning and motor capacity, language, speech, and literacy. The review offers a starting point for the construction of a formal assessment instrument encompassing the aforementioned categories, along with duly validated guidelines for its application. What are the potential or actual clinical implications of this work? Our formal assessment instrument takes into account the need to adapt to different patient profiles. It is hoped that it will provide speech therapists and other health professionals with the information required to implement an AACS in which patients participate actively.