Prevalence Of Edema Research Articles

Incidence and Prevalence of Edema and the Effect of Aprocitentan Treatment Strategy in the PRECISION Study

Incidence and Prevalence of Edema and the Effect of Aprocitentan Treatment Strategy in the PRECISION Study

Characterization of Adverse Outcomes from Legacy-Contaminated Groundwater Exposure to Early Life Stages of Fathead Minnow.

Complex mixtures of chemicals present in groundwater at legacy-contaminated industrial sites can pose significant risks to adjacent surface waters. The combination of short-term molecular and chronic apical effect assessments is a promising approach to characterize the potential hazard of such complex mixtures. The objectives of this study were to: (1) assess the apical effects (survival, growth, development, and liver histopathology) after chronic exposure of early life stages (ELSs) of fathead minnows (FHM; Pimephales promelas) to contaminated groundwater from a legacy-contaminated pesticide manufacturing and packaging plant, and (2) identify possible molecular mechanisms responsible for these effects by comparing results to mechanistic outcomes previously determined by a short-term reduced transcriptome assay (EcoToxChips). This study revealed a significant increase in mortality and prevalence of spinal curvatures, as well as a significant reduction in the length of FHMs exposed to the groundwater mixtures in a concentration-dependent manner. There was an increasing trend in the prevalence of edema in FHMs, though not significantly different from controls. Additionally, no histopathological effects were observed in the liver of FHMs exposed to the groundwater mixtures. Short-term molecular outcomes determined in a parallel study were found to be informative of chronic apical outcomes, including cardiotoxicity, spinal deformities, and liver toxicity. Overall, the results observed in this study demonstrated that short-term transcriptomics analyses could support the hazard assessment of complex contaminated sites.

Analysis of the effect of nursing care based on action research method on the prevention of postoperative lymphedema in breast cancer patients

Rationale: In recent times, the pervasive adoption of the action research method has garnered substantial attention both domestically and internationally. Its integration has traversed various domains of nursing research, nursing education, and nursing practice, yielding commendable outcomes. However, a notable gap persists, as this method remains untapped in the realm of nursing care concerning the prevention of postoperative lymphedema in breast cancer patients. Diagnosis: To employ the action research methodology in the context of patients undergoing axillary lymph node dissection surgery for breast cancer, aiming to investigate its impact on mitigating postoperative lymphedema and assessing its influence on the patient’s quality of life, as well as levels of anxiety and depression postoperatively. Intervention: The study focused on breast cancer patients admitted to our hospital from January 2022 to December 2022. Among them, 44 patients from January to June constituted the control group, while 44 patients from July to December comprised the observation group. Conventional nursing measures were applied to the control group, whereas the observation group received nursing interventions rooted in the action research method. A comparative analysis was conducted between the 2 groups, assessing the incidence of postoperative lymphedema, daily life ability, as well as levels of anxiety and depression. Outcomes: The prevalence of edema was notably reduced in the observation group (20.93%) compared to the control group (42.22%), with a statistically significant difference. Throughout the study, patients in both groups exhibited increased Barthel Index Scale scores from the study’s initiation, and the scores for the observation group surpassed those of the control group, reaching statistical significance (P < .05). Furthermore, by the study’s conclusion, anxiety and depression scores for patients in both groups were diminished compared to the study’s commencement, and the observation group demonstrated significantly lower scores in anxiety and depression compared to the control group (P < .05). Lessons: The implementation of nursing care grounded in the action research methodology exhibits a capacity to diminish both the occurrence and intensity of postoperative lymphedema in breast cancer patients. Concurrently, it enhances the patients’ daily life functionality and mitigates symptoms of anxiety and depression.

Abstract 251: Brain Computed Tomography After In-Hospital Cardiac Arrest

Background: Brain computed tomography (CT) is useful to identify early cerebral edema after cardiac arrest and neurological causes arrest. Most early CT data come from out-of-hospital cardiac arrest (OHCA). The prevalence of edema and neurological causes of arrest is unknown after in-hospital cardiac arrest (IHCA). Purpose: To compare the frequency of edema and neurologic causes of arrest after IHCA and OHCA. Methods: We identified patients treated at a single medical center between January 2010 and August 2020 who had a brain CT within 24 hours of arrest. We abstracted age, sex, initial cardiac rhythm, duration of arrest, and survival to hospital discharge in all patients, and cause of death in decedents. We measured grey to white matter ratio (GWR) at the level of the basal ganglia. We categorized GWR as normal (1.30), mild edema (>1.20 and <1.30), and severe (1.20). We compared age, duration of arrest, GWR and edema category by arrest location using Wilcoxon-Rank-Sum and Fisher’s Exact tests. Results: Of 2,413 subjects (464 (19%) IHCA and 1949 (81%) OHCA), 1,725 had a brain CT within 24 hours of collapse (IHCA n=157, 9%; OHCA n=1,568, 91%) and were included. Subjects who suffered IHCA were significantly older (median 64 [interquartile range (IQR) 54 - 74] years vs 59 [IQR 49-70] years), had shorter CPR durations (IHCA median 10 [IQR 5-18] vs OHCA median 21 [IQR 13 - 34], p <0.001) and higher GWR (IHCA median 1.33 [1.29 - 1.41], OHCA median 1.3 [1.20 - 1.36], p<0.001). Severe edema was less common in IHCA (n=8, 5%) than OHCA (n=270, 24%). Mild edema was common after IHCA (n=49, 32%). Few CT scans revealed a neurological etiology of arrest (IHCA n=3, 2%; OHCA n=63, 4%). In-hospital death increased with edema, (no edema, n=48, 50%; mild, n=36, 73%; severe, n=8, 100%). Among deaths, 50% were attributed to perceived poor neurological prognosis. Conclusions: While severe edema is not as common as after OHCA, mild edema is relatively common after IHCA. Preventing and treating cerebral edema is important for survivors of IHCA.

A randomised controlled multicentre investigator-blinded clinical trial comparing efficacy and safety of surgery versus complex physical decongestive therapy for lipedema (LIPLEG)

BackgroundLipedema is a chronic disorder of the adipose tissue that affects mainly women, characterised by symmetrical, excessive fatty tissue on the legs and pain. Standard conservative treatment is long-term comprehensive decongestive therapy (CDT) to alleviate lipedema-related pain and to improve psychosocial well-being, mobility and physical activity. Patients may benefit from surgical removal of abnormally propagated adipose tissue by liposuction. The LIPLEG trial evaluates the efficacy and safety of liposuction compared to standard CDT.Methods/designLIPLEG is a randomised controlled multicentre investigator-blinded trial. Women with lipedema (n=405) without previous liposuction will be allocated 2:1 to liposuction or CDT. The primary outcome of the trial is leg pain reduction by ≥2 points on a visual analogue scale ranging 0–10 at 12 months on CDT or post-completion of liposuction. Secondary outcomes include changes in leg pain severity, health-related quality of life, depression tendency, haematoma tendency, prevalence of oedema, modification physical therapy scope, body fat percentage, leg circumference and movement restriction.The primary analysis bases on intention-to-treat. Success proportions are compared using the Mantel-Haenszel test stratified by lipedema stage at a 5% two-sided significance level. If this test is statistically significant, the equality of the response proportions in the separate strata is evaluated by Fisher’s exact test in a hierarchical test strategy.DiscussionLIPLEG assesses whether surgical treatment of lipedema is safe and effective to reduce pain and other lipedema-related health issues. The findings of this trial have the potential to change the standard of care in lipedema.Trial registrationClinicalTrials.gov NCT04272827. Registered on February 14, 2020.Trial statusProtocol version is 02_0, December 17, 2019

Prevalence and Impact of Chronic Edema in Bariatric Patients: A LIMPRINT Study.

Background: Chronic edema (CO) is a complex condition, arising from different factors, including immobility and obesity. Edema and obesity can have a significant impact on quality of life of patients and their families. Understanding how to manage edema in obese patients is an increasing challenge for both patients and clinicians. As effective treatment options are limited for this population, it is more cost-effective for patients to lose weight before starting treatment. When patients cannot maintain weight loss, one option is to have bariatric surgery. This study was part of LIMPRINT: Lymphedema IMpact and PRevalence INTernational, a study with the aim of identifying the prevalence and impact of CO in different countries and health care settings. Study Purpose: To evaluate the prevalence and impact of CO among patients in a United Kingdom bariatric surgical service. Methods and Results: The gold standard pitting test assessed the presence of edema. General (EuroQOL-5 Dimensions [EQ-5D], RAND 36-Item Short Form Health Survey, Version 1.0 [SF-36], Generalized Anxiety Disorder 7-Item Scale [GAD-7] and Patient Health Questionnaire-9 [PHQ-9]), and edema-specific (Lymphedema Quality of Life [LYMQOL]) quality-of-life questionnaires were used to evaluate impact of edema. The prevalence of edema was 52.1% (25 of 48 participants had edema), potentially linked to obesity, immobility, and medications. Most participants had International Society of Lymphology (ISL) Stage I edema. There were no statistically significant differences between the quality of life of participants with and without edema. However, comparing SF-36 results and normative population data indicated that quality of life was much lower than those in the normative population. Conclusions: This study highlights the high prevalence of edema and low quality of life of this bariatric population. ClinicalTrials.gov ID: NCT03154593.

Role of Diffusion Tensor Imaging and Motor Functional MRI in Preoperative Assessment of Brain Tumors

Diffusion tensor imaging is a non-invasive magnetic resonance imaging technique that describe the orientation and location of white matter tracts in vivo, it guides the surgeon regarding the relationship of the intra-axial tumor to adjacent white matter tracts in different planes. Routine pre-surgical FMRI allows for assessment of the relationship between brain tumor and motor cortex to facilitate function-preserving surgery and reduce postoperative morbidity. The purpose of this study is to evaluate role of diffusion tensor magnetic resonance imaging, fiber tractography and motor functional MRI in assessment of white matter tracts affected by the tumor, and to utilize this information in guiding surgeons. Fifty patients with different types of brain tumors were enrolled in this study. Fiber tracts involvement were classified into four categories (edema, displacement, infiltration and disruption), comparison between benign and malignant tumors groups as regards to the patterns of fiber tracts involvement were done. The prevalence of edema and displacement was higher among the benign group while prevalence of infiltration and disruption was higher among the malignant group. Localization of the primary motor hand area with functional MRI was done, The relation of it to the tumor was measured. Treatment plans before and after DTI & functional MR imaging differed in 35 patients as regard to surgical approach and in 17 patients as regard to modification of extent of resection with significant relation. Diffusion tensor imaging DTI represents recent important progress in the field of diagnostic imaging. It is the only technique that is able to visualize in vivo white-matter tracts so that it is of great help in pre-operative neurosurgical planning.

Prospective Evaluation of the Time Course of White Matter Edema Associated with Implanted Deep Brain Stimulation Electrodes

Introduction: Deep brain stimulation (DBS) is commonly used in the treatment of medically refractory movement disorders. There have been several reports in the literature of edema developing around the implanted electrode. Most of these studies have been retrospective, suggesting that the time course and incidence of this edema are underestimated. An understanding of the incidence and time course of edema related to DBS leads is important to allow clinicians to better assess the correct course of action when edema following DBS implantation is observed. Methods: We examined both the time course and prevalence of edema following DBS implantation by obtaining a series of postoperative MRI scans from patients who underwent DBS surgery. Edema volume was quantified by a single neuroradiologist, measuring the peri-electrode T2 signal change. Results: We examined postoperative MRIs in thirteen patients with fifteen DBS electrode implants. Eleven patients exhibited white matter edema on at least 1 postoperative MRI, with none being symptomatic. Edema was completely resolved in 4 of the electrode implants through postoperative day 70, with the remaining cases still exhibiting edema at the last imaged time point. Discussion/Conclusion: In this study, we obtained a regimented series of postoperative MRIs in an effort to determine the time course and incidence of edema. Our results show that edema following DBS implant is not rare, is often asymptomatic, and may resolve over many weeks.

Prevalence of acute malnutrition among children ages 6-59 months: Results from a baseline nutrition survey in North-Western Uganda

Background: Acute malnutrition is particularly important in humanitarian emergencies where sudden change of food availability or high disease burden can cause this form of malnutrition. Alliance Forum for Development Uganda received funding from World Food Program to implement MCHN and TSFP in refugee settlement areas in Koboko district, North-western Uganda. As part of the program, a baseline nutrition survey was conducted to fast track the progress and contribution of the project towards improving the nutritional wellbeing of the refugees and host communities. Methods: A cross-sectional study was carried out in the month of August in two sub counties in Koboko district. The selection of the sub counties and parishes therein was purposive, while 18 villages in selected parishes were randomly selected. The participants were invited to come to the nearest screening post for anthropometric measurements. Anthropometric data was analyzed using ENA software. While Stata version 12 was used to execute statistical tests for association. Statistical tests were two-sided. Results: The prevalence of GAM was 5.6% (4.2-7.4 95% C.I.) and SAM was 1.1% (3.2-5.8 95% C.I.). GAM was higher among boys than in girls (7.7% vs. 3.9%). There were no statistically significant differences in prevalence of acute malnutrition by nationality (national: 8.7% vs. refugees: 6.2%, p=0.186). Low child birth weight was statistically associated with acute malnutrition (p=0.021). Severe acute malnutrition was more common among the age group 6-17 months (1.2%) and decreased with age. The prevalence of oedema was 0.6%. Conclusion: By WHO thresholds, our results indicate that global acute malnutrition is a moderate situation in the refugee areas of Koboko district and that GAM affects both refugees and host communities. We recommend a repeat of the survey during a period of hunger gap to give a year-round nutrition situation in Koboko district.

Ethmoid Drug‐Eluting Catheter for Nasosinusal Polyposis: Results after a Randomized Controlled Trial

Objectives: Assess the safety and efficacy of a drug-eluting catheter to be inserted into the ethmoid sinuses during endoscopic sinus surgery to elute triamcinolone in patients with CRSwP (nasosinusal polyposis). Methods: Prospective, randomized, controlled, double-blind, clinical trial using intrapatient control design. The study enrolled 40 patients with CRSwP undergoing endoscopic sinus surgery. In every case, after polypectomy was done to expose the ethmoid bulla, a drug-eluting catheter to elute triamcinolone (0.3 mL) was randomly applied to one nasal fossa, whereas the other was treated by conventional total ethmoidectomy. Outcome measures were visual analogue scales, Rhinosinusitis Disability Index, endoscopy, and olfactometry assessment at baseline, 3, 6, and 12 months. Safety assessments included ocular examinations at baseline and 30 days. All CT imaging was done after more than 12 months of follow-up. Results: After randomization was performed, unilateral devices were successfully placed in all patients and easily removed after 4 weeks. When comparing both nasal fossae in postoperative endoscopies at 6 and 12 months, the prevalence of edema, adhesions, and recurrent polyposis were statistically similar. Changes from baseline in patient-reported outcomes were statistically relevant in both sides. No clinically important changes in intraocular pressure occurred. CT resolution of pathology was achieved in both sides, improving Lund-Mackay scale, without significant differences. Conclusions: This trial provides clinical evidence on the safety and efficacy of a drug-eluting catheter for use in patients with CRSwP. It achieves similar results compared to complete ethmoidectomy, without any major complications.

Effect of Nutritional Support on Terminally Ill Patients With Cancer in a Palliative Care Unit

The role of nutritional support on terminally ill patients with cancer in a palliative care unit has not been clarified. A total of 63 patients were retrospectively investigated; the patients receiving individualized nutritional support (intervention group [n = 22]) were compared to the others (control group [n = 41]). The intervention group received individualized nutritional support. There were no significant differences in the characteristics of patients between the groups. The prevalence of bedsores was significantly lower in the intervention group (14% vs 46%, P = .012). The prevalence of edema and the use of antibiotic therapies tended to be lower in the intervention group than in the control group (36% vs 54%, P = .19; 14% vs 27%, P = .34, respectively). Some terminally ill patients with cancer in a palliative care unit might benefit from nutritional support.

Nutritional factors in corneal xerophthalmia and keratomalacia.

Six measures of nutritional status were studied in 162 consecutive cases of presumed nutritional keratopathy ranging from mild xerosis through full-thickness necrosis (keratomalacia) and in a variety of control subjects. The severity of corneal involvement was related to the severity of wasting, prevalence of edema, and serum levels of albumin, transferrin, and vitamin A. Even the most severe corneal alterations were compatible with normal indices of protein and anthropometric status, but not with normal serum vitamin A levels. Analysis suggests that interaction between vitamin A and protein status determines cellular adequacy of vitamin A metabolism, which virtually collapses in keratomalacia. Serum levels of holoretinol-binding protein were severely and uniformly depressed in all degrees of corneal involvement.

Effect of food supplementation on blood pressure and on the prevalence of edema and proteinuria during pregnancy.

Effect of food supplementation on blood pressure and on the prevalence of edema and proteinuria during pregnancy.

Sex Variation in the Nutritional State of Urban Zulu Adults: II. Serum Protein Levels and Prevalence of Edema

T HIS paper comprises a further report on an investigation into the occurrence of sex differences in the nutritional state of a population saliiple of Zulu adults residing in a housing schenie for Africans in the city of Durban, South Africa. A previous report has dealt with the findings in respect to weight, skinfold thickness and the mucocutaneous signs of malnutrition.’ The present report deals with the findings in respect to serum protein levels and the prevalence of edema.