Significant Differences In Pressure Research Articles

Comparing the hemodynamic changes, bleeding, and surgeon’s satisfaction during rhinoplasty surgery by use of two drugs, labetalol and dexmedetomidine added to anesthetic technique: a randomized clinical trial

Background: Rhinoplasty is a common surgery in the world. Bleeding is a common concern during rhinoplasty. Hemodynamic stability and quality of view of the surgical field help to achieve the best results. The aim was to compare the effect of two drugs, dexmedetomidine and labetalol, on the amount of bleeding and satisfaction with rhinoplasty surgery. Methods: A cross-sectional descriptive study includes candidates for rhinoplasty surgery, referring to Moradi Hospital in Rafsanjan. Twenty patients were assigned to each group (dexmedetomidine and labetalol) based on the entry and exit criteria. Systolic and diastolic blood pressures and mean arterial pressure were measured before, 20 minutes after complete anesthesia, and the start of rhinoplasty surgery. All patients were operated by the same surgeon using the same technique. The surgeon’s level of satisfaction indicated with the field of vision is given as follows: good, moderate, and poor. Results: The study was performed on 40 subjects in two groups (n = 20), of which 14 (35 %) were male and 26 (65 %) were female. The results presented statistically significant differences in mean osteotomy systolic blood pressure (P = 0.018), osteotomy diastolic blood pressure (P = 0.015), mean osteotomy arterial pressure (P = 0.002), after 20 minutes heart rate (P < 0.001), and osteotomy heart rate (P = 0.001) between two groups. Furthermore, significant differences were observed regarding systolic blood pressure (P = 0.015), mean arterial pressure (P = 0.03), and heart rate (P < 0.001) after controlling for the effect of the group. Conclusions: The labetalol is the preferred option for controlling hypotension that provides better surgical field visibility compared to dexmedetomidine in rhinoplasty surgery.

Effects of Aerobic Exercise and Yoga on Blood Pressure in Women Between the Ages of 30 and 40 Years

High blood pressure or hypertension is a major risk factor for cardiovascular disease. This study aims to prove the effectiveness of aerobic exercise and yoga in lowering blood pressure in mothers. The study was conducted using experimental methods and involved 28 participants selected by purposive sampling from Nogosari village, Boyolali regency, Indonesia, during 12 sessions. Blood pressure data were collected from participants with hypertension before and after aerobic exercise and yoga. Measurements were taken on participants for 12 sessions in one month using a blood pressure monitor. The device used in this study was a sphygmomanometer ambulatory blood pressure monitoring (ABPM). Statistical tests were performed using independent samples t-tests with a significance level of p <0.05. The results of the homogeneity test showed that the systolic and diastolic variance in the control and experimental groups had the same variance with a significance level of p < 0.05. The results of both mean difference tests showed that there were significant differences in systolic and diastolic blood pressure between the aerobic and yoga groups. This can be seen from the value of P-value Independent Samples t-test < 0.05. The results showed that low-impact aerobic exercise and yoga had a significant effect on blood pressure in women aged 30-40 years. Based on these data, it can be concluded that there is a significant decrease in systolic and diastolic blood pressure from the category of moderate hypertension to normal-high in women aged 30-40 years after doing aerobic exercise and yoga.

Alfentanil versus fentanyl for emergency department rapid sequence induction with ketamine: A-FAKT, a pilot randomized trial

BackgroundFentanyl is often administered during rapid sequence induction of anesthesia (RSI) in the emergency department (ED) to ameliorate the hypertensive response that may occur. Due to its more rapid onset, the use of alfentanil may be more consistent with both the onset time of the sedative and the commencement of laryngoscopy. As such, we compared the effect of alfentanil and fentanyl on post-induction hemodynamic changes when administered as part of a standardized induction regimen including ketamine and rocuronium in ED RSI. MethodsThis was a double-blind pilot randomized controlled trial of adult patients requiring RSI in the ED of three urban Australian hospitals. Patients were randomized to receive either alfentanil or fentanyl in addition to ketamine and rocuronium for RSI. Non-invasive blood pressure and heart rate were measured immediately before and at two, four, and six minutes after induction. The primary outcome was the occurrence of at least one post-induction systolic blood pressure outside the pre-specified range of 100-160mmHg (with adjustment for patients with baseline hypertension). Secondary outcomes included hypertension, hypotension, hypoxia, first-pass intubation success, 30-day mortality, and the pattern of hemodynamic changes. ResultsA total of 61 patients were included in the final analysis (31 in the alfentanil group and 30 in the fentanyl group). The primary outcome was met in 58% of the alfentanil group and 50% of the fentanyl group (difference 8%, 95% confidence interval: -17% to 33%). The 30-day mortality rate, first-pass success rate, and incidences of hypertension, hypotension, and hypoxia were similar between the groups. There were no significant differences in systolic blood pressure or heart rate between the groups at any of the measured time-points. ConclusionAlfentanil and fentanyl produced comparable post-induction hemodynamic changes when used as adjuncts to ketamine in ED RSI. Future studies could consider comparing different dosages of these opioids.

The effect of light massage and Spiritual Emotional Freedom Technique interventions on blood pressure among hypertension patients in Indonesia

Hypertension remains a significant global public health concern. Non-pharmacological interventions such as light massage and the Spiritual Emotional Freedom Technique (SEFT) offer potential avenues to mitigate sustained increases in blood pressure among patients with hypertension. However, research exploring these methods as alternative therapies, particularly in Indonesia, is limited. This study aimed to investigate the effects of light massage and SEFT on the blood pressure of hypertensive individuals. Employing a quasi-experimental design with a time series approach, the study utilized purposive sampling to select 27 participants. Light massage and SEFT were considered independent variables, while blood pressure served as the dependent variable. Data analysis involved repeated measures ANOVA and one-way ANOVA tests. The results revealed significant differences in mean blood pressure before and after the light massage intervention (p-values: 0.002, <0.001, <0.001). The intervention sessions yielded the most significant results (p-values: <0.001, 0.002, <0.001), whereas no differences were observed in the control group (systolic and Mean Arterial Pressure, MAP, p-values: 0.012 and 0.017, respectively). Notably, there were discrepancies in mean blood pressure before and after interventions in both the light massage and SEFT groups, indicating a potential benefit of these interventions. Conversely, no such differences were noted in the control group. These results highlight the potential benefits of integrating light massage and SEFT into holistic approaches for managing hypertension, potentially improving outcomes and quality of life for affected individuals.

Comparison of alfentanil and fentanyl in painless colonoscopy in children

[Objective] To explore the safety and efficacy of alfentanil and fentanyl combined with propofol in painless colonoscopy in children. [Methods] 60 children aged 3-7 years old who were going to do colonoscopy in our hospital were randomly divided into alfentanil group (AF group) and fentanyl group (F group), with 30 cases in each group. The dosage of alfentanil 10ug/kg and fentanyl 2ug/kg respectively were used in both groups. The recovery time, induced cough, vital signs, physical activity, drug supplementation, postoperative adverse reactions and doctor satisfaction of the two groups of children were observed and recorded. [Results] The recovery time of AF group was shorter than that of F group, which was (11.40±4.33) minutes and (9.37±2.81) minutes respectively (P< 0.05). The induced cough in AF group was less than that in F group (P< 0.05). AF group had more body motion than F group (P< 0.05). There were no significant differences in blood pressure, heart rate, oxygen saturation, respiratory rate and other vital signs between the two groups (P> 0.05), but the values of vital signs at all observation points in the two groups were lower than those before anesthesia. No adverse reactions occurred in the two groups, and there was no significant difference in the satisfaction of doctors between the two groups. [Conclusion] Both alfentanil and fentanyl can be effectively used in painless colonoscopy in children. However, alfentanil is more suitable for painless colonoscopy than fentanyl due to its shorter resuscitation time, lower incidence of induced cough and no increased risk of adverse reactions.

Evaluating handwriting in children with developmental coordination disorder (DCD): Temporal, spatial, pressure and grip-force measures

BackgroundWriting involves complex sensorimotor and biomechanical processes that regulate pressure on the writing surface. Researchers analyze writing to understand kinetics and kinematics by evaluating temporal, spatial, and pressure aspects, yet discerning writing surface pressure and pen-grip force remains challenging. AimsTo compare handwriting kinetics (pen grip-force and surface pressure) and kinematics (temporal-spatial) of children with developmental coordination disorder (DCD) with those of typically developing (TD) children. Methods and proceduresTwenty-seven children with DCD aged 7–12 years and 27 TD children matched by age and gender copied a 29-word passage onto a computerized tablet. Temporal, spatial and surface pressure as well as pen grip-force were measured with a tablet and a wearable device respectively. Outcomes and resultsThe DCD group displayed significantly longer total writing time, mean letter time, and greater letter height, width, variance, spacing, area, and erasures than the TD group. Although there were no significant between-group differences in the surface pressure or maintaining pressure, the DCD group displayed weaker grip-force, p = .01, with greater variance. Conclusions and implicationsThe DCD group's weaker grip-force dynamics correlated with reduced legibility, form, and prolonged writing duration, revealing insights into handwriting mechanisms, particularly grip force, crucial for effective clinical interventions.

TLR4 deficiency does not alter glaucomatous progression in a mouse model of chronic glaucoma.

Glaucoma is a leading cause of irreversible blindness worldwide. Toll-like receptor 4 (TLR4) is a pattern-recognition transmembrane receptor that induces neuroinflammatory processes in response to injury. Tlr4 is highly expressed in ocular tissues and is known to modulate inflammatory processes in both anterior and posterior segment tissues. TLR4 activation can lead to mitochondrial dysfunction and metabolic deficits in inflammatory disorders. Due to its effects on inflammation and metabolism, TLR4 is a candidate to participate in glaucoma pathogenesis. It has been suggested as a therapeutic target based on studies using acute models, such as experimentally raising IOP to ischemia-inducing levels. Nevertheless, its role in chronic glaucoma needs further evaluation. In the current study, we investigated the role of TLR4 in an inherited mouse model of chronic glaucoma, DBA/2J. To do this, we analyzed the effect of Tlr4 knockout (Tlr4 -/-) on glaucoma-associated phenotypes in DBA/2J mice. Our studies found no significant differences in intraocular pressure, iris disease, or glaucomatous progression in Tlr4 -/- compared to Tlr4 +/+ DBA/2J mice. These data do not identify a role for TLR4 in this chronic glaucoma, but further research is warranted to understand its role in other glaucoma models and different genetic contexts.

Research on the Coordinated Development of Digital Economy, Green Technology Innovation, and Ecological Environment Quality—A Case Study of China

Based on panel data from 285 prefecture-level cities in China from 2019 to 2023, the synergistic effects of the digital economy, green technology innovation, and ecological environment quality were analyzed. First, using the entropy method, the measurement dimensions of the indicators of the digital economy, green technology innovation, and ecological environment quality were obtained. Second, employing a neural network model with these measurements as input variables, the interactive relationship among the digital economy, green technology innovation, and ecological environment quality was explored. Finally, based on the calculation results of the neural network model, the importance and impact of each input parameter on ecological environment quality were determined using weight analysis methods. The research findings indicate: (1) Utilizing the entropy method, the measurement dimensions of the indicators of the digital economy, green technology innovation, and ecological environment quality were obtained. Analysis of each indicator measurement reveals that environmental pressure has a significant impact on ecological environment quality, with significant differences in environmental pressure among different regions. Industrial digitization emerges as the core factor influencing the digital economy, being the most significant driving effect, followed by digital industrialization. Green technology innovation is crucial for promoting environmental protection and achieving high-quality green economic development. (2) Based on the neural network model, the interactive relationship among the digital economy, green technology innovation, and ecological environment quality was revealed. The results indicate that the digital economy has a direct impact on improving ecological environment quality. The relationship between the digital economy and the ecological environment exhibits nonlinear effects, with the rate of change in environmental pressure and environmental status measurements initially increasing significantly and then gradually slowing down as the measurement levels of digital industrialization and industrial digitization increase. Improvement in digital governance and data value measurement levels will contribute to enhancing environmental status and environmental governance levels. (3) Through weight analysis, it was found that in terms of direct effects, industrial digitization, and digital industrialization have the most significant impact on environmental pressure, with importance coefficients of 0.45 and 0.3, respectively, while data valorization has the least impact. Regarding intermediary effects, industrial digitization and green technology innovation have the most significant impact on environmental pressure, while digital governance and green technology innovation have a relatively clear impact on environmental status and environmental governance. These results lay the foundation for promoting the coordinated cooperation between the digital economy and green technology innovation and for advancing the establishment of a win–win situation between economic development and environmental protection.

Physiological Effects and Tolerance of Wearing Surgical and N95 Masks during Sleep in Normal Individuals and Patients with Mild-Moderate Obstructive Sleep Apnea: A Randomized Crossover Trial

BackgroundIn certain situations, masks are worn during sleep to prevent respiratory infections. However, the effects of mask wearing on cardiopulmonary function during sleep are unknown. This study aimed to determine whether wearing masks during sleep has an impact on cardiopulmonary function, including in patients with obstructive sleep apnea. MethodsThis was a prospective, randomized crossover-controlled trial. The effects of wearing surgical masks or N95 respirators on cardiopulmonary function were measured in healthy subjects and patients with mild-moderate obstructive sleep apnea. Sleep breathing parameters were monitored during nocturnal sleep using a sleep monitor, and subjective feelings about mask wearing were assessed using a questionnaire. ResultsWearing masks during sleep at night did not significantly impact sleep breathing parameters. Furthermore, there were no significant differences in heart rate, blood oxygenation, and blood pressure before and after wearing masks. However, wearing masks, especially the N95 mask, had an adverse impact on sleep quality, and masks were found to be subjectively uncomfortable. ConclusionWearing masks during sleep at night does not adversely affect cardiopulmonary function but they can be uncomfortable, especially the N95 mask. Thus, in circumstances where wearing N95 masks during nocturnal sleep proves intolerable, we recommend the use of surgical masks as a more comfortable alternative.

Analysis of the Correlation Between Dynamic Characteristics and Symptoms of Gastroesophageal Reflux Disease.

To investigate the esophageal motility characteristics of gastroesophageal reflux disease (GERD) and their relationship with symptoms. We examined 101 patients diagnosed with GERD by endoscopy and divided them into 3 groups as follows: nonerosive reflux disease (NERD), reflux esophagitis, and Barrett esophagus. Esophageal high-resolution manometry and the GERD Questionnaire were used to investigate the characteristics of esophageal dynamics and symptoms. In addition, the reflux symptom index was completed and the patients were divided into 7 groups according to symptoms. We then determined the correlation between dynamic esophageal characteristics and clinical symptoms. Upper (UES) and lower (LES) esophageal sphincter pressures and the 4-second integrated relaxation pressure in the RE group were lower than those in the NERD group. The 4-second integrated relaxation pressure in the Barrett esophagus group was also lower than that in the NERD group. In the analysis of extraesophageal symptoms, high-resolution manometry showed significant differences in UES pressures among all groups. Further subgroup analysis showed that compared with the group without extraesophageal symptoms, the UES pressure of the groups with pharyngeal foreign body sensation, throat clearing, and multiple extraesophageal symptoms was lower. As GERD severity increases, motor dysfunction of the LES and esophageal body gradually worsens, and the LES plays an important role in GERD development. Decreased UES pressure plays an important role in the occurrence of extraesophageal symptoms, which is more noticeable in patients with pharyngeal foreign body sensation and throat clearing.

The effects of caffeine ingestion on blood pressure levels in athletic and non-athletic women.

Caffeine is one of the most widely consumed pharmacological substances globally, and is known for its potential ergogenic effects. This study examined the impact of caffeine on the blood pressure in athletic and non-athletic women. Caffeine, a CNS stimulant, enhances athletic performance by boosting stamina, alertness, and cognitive speed. The aim of this study was to assess the impact of caffeine on heart rate and blood pressure in both athletic and non-athletic women, and to inform both groups about its effects. The study was conducted in the Kingdom of Saudi Arabia and involved 30 volunteers aged 18-30 years. Participants were equally divided into three groups: athletes who consumed caffeine, non-athletes who consumed caffeine, and a control group (given a placebo). After caffeine ingestion, there were no significant differences in diastolic blood pressure (DBP), systolic blood pressure (SBP), or heart rate between athletes and non-athletes. These findings suggest that caffeine consumption does not significantly affect blood pressure in either athletic or non-athletic women. However, if it raises blood pressure in both groups, it could pose risks, prompting athletes to consider alternative hydration options such as Gatorade.

Efficacy and Safety of Intravenous Magnesium Sulfate in Spinal Surgery: A Systematic Review and Meta-Analysis.

Optimizing pain management in spinal surgery is crucial for preventing adverse events due to delayed mobilization. Magnesium sulfate has potential benefits in spinal surgery because of its analgesic properties and modulation of neurotransmitters and autonomic nervous system. Existing evidence regarding the use of magnesium sulfate is partial and controversial, necessitating a comprehensive meta-analysis to evaluate its efficacy and safety. The aim of this study was to conduct a comprehensive meta-analysis to evaluate the efficacy and safety of magnesium sulfate in spinal surgery compared to other available options. This meta-analysis adhered to the PRISMA guidelines. Patients undergoing spinal surgery were included, with the intervention group receiving intravenous magnesium sulfate (MS) at various doses or combinations, whereas the comparison group received other alternatives or a placebo. The efficacy and safety outcomes were assessed. Data were collected from multiple databases and analyzed using Review Manager version 5.4. Heterogeneity was assessed and fixed- or random-effects models were applied. The meta-analysis included eight studies (n = 541). Magnesium sulfate demonstrated significant reductions in pain at 24 h (MD -0.20, 95% CI: -0.39 to -0.02) and opioid consumption (SMD -0.66, 95% CI: -0.95 to -0.38) compared to placebo. Additionally, a decrease in the use of muscle relaxants (SMD -0.91, 95% CI: -1.65 to -0.17) and remifentanil (SMD -1.52, 95% CI: -1.98 to -1.05) was observed. In contrast, an increase in extubation time (MD 2.42, 95% CI: 1.14 to 3.71) and verbal response (MD 1.85, 95% CI: 1.13 to 2.58) was observed compared to dexmedetomidine. In conclusion, magnesium sulfate administration in spinal surgery reduced pain and opioid consumption, and prolonged orientation and verbal response. No significant differences in blood pressure or heart rate were observed between the groups.

Age and Sex-related Chromogranin A Gene Polymorphisms and its Association with Metabolic Syndrome Components.

The purpose of this study was to determine the possible differences in genetic polymorphisms and serum levels of chromogranin A (CgA), according to age and sex, in subjects with and without metabolic syndrome (MetS). The genotyping and serum level of CgA and biochemical parameters were measured by the T-ARMS-PCR and PCR-RFLP and ELISA and spectrophotometer methods, respectively. A comparison of males with and without MetS showed significantly lower high-density lipoprotein-cholesterol (HDL-C) levels than those of females.At ages 30-70 years, both sexes showed significant differences in triglycerides (TG), fasting blood sugar (FBS), CgA levels and waist circumference (WC) when compared to the two groups. Both sexes with MetS indicated significant differences in systolic blood pressure (SBP) at ages 40-70 years, while at ages 40-59 years, there was a significant difference in HDL-C level in males.There was a significant correlation between serum levels of FBS, TG, SBP and WC (in both sexes), and CgA in subjects with MetS. Significant correlation was found between HDL-C level and diastolic blood pressure (DBP), and CgA level in males and females, respectively. CgA genotype frequency (T-415C and C+87T polymorphisms) showed no significant differences between males and females with and without MetS, while there was only a significant difference in frequency of the genotypes T-415C when compared to males with and without MetS. The CgA appears to be strongly associated with MetS components in both sexes. Variation in CgA gene expression may affect the T-415C polymorphism in males. This may mean that the structure of CgA genetics differs in different ethnic groups. Differences in the serum level and expression of CgA gene may show valuable study results that it may be expected a relationship between these variables and the MetS.

Acute cardiovascular and muscular response to rowing ergometer exercise in artificial gravity – a pilot trial

Prolonged immobilization and spaceflight cause cardiovascular and musculoskeletal deconditioning. Combining artificial gravity through short-arm centrifugation with rowing exercise may serve as a countermeasure. We aimed to compare the tolerability, muscle force production, cardiovascular response, and power output of rowing on a short-arm centrifuge and under terrestrial gravity. Twelve rowing athletes (4 women, aged 27.2 ± 7.4 years, height 179 ± 0.1 cm, mass 73.7 ± 9.4 kg) participated in two rowing sessions, spaced at least six weeks apart. One session used a short-arm centrifuge with +0.5 Gz, while the other inclined the rowing ergometer by 26.6° to mimic centrifugal loading. Participants started self-paced rowing at 30 W, increasing by 15 W every three minutes until exhaustion. We measured rowing performance, heart rate, blood pressure, ground reaction forces, leg muscle activation, and blood lactate concentration. Rowing on the centrifuge was well-tolerated without adverse events. No significant differences in heart rate, blood pressure, or blood lactate concentration were observed between conditions. Inclined rowing under artificial gravity resulted in lower power output (−33%, p < 0.001) compared to natural gravity, but produced higher mean and peak ground reaction forces (p < 0.0001) and increased leg muscle activation. Muscle activation and ground reaction forces varied with rotational direction. Rowing in artificial gravity shows promise as a strategy against cardiovascular and muscular deconditioning during long-term spaceflight, but further investigation is required to understand its long-term effects.

#1870 Uninephrectomized diabetic rats delay onset of hyperglycemia via down-regulation of SGLT2 mRNA

Abstract Background and Aims The kidney is essential for glucose metabolism. Reabsorption of almost all the glucose filtered by the glomerulus is performed by the sodium-glucose cotransporters (the SGLTs) in the proximal tubules, with SGLT2 responsible for about 90%. In addition, the kidney, along with the liver, plays an important role in gluconeogenesis, especially in the long fasting state. SGLT2 inhibitors originally developed for the treatment of type 2 diabetes mellitus (DM) are clinically very effective drugs halting chronic kidney disease progression. The underlying mechanisms are, however, not fully understood. Furthermore, SGLT2 expression in diabetic patients has been reported to increase and decrease but remains unclear. Therefore, this study aimed to evaluate how uninephrectomy (UNx) and SGLT2 inhibitor treatment affects the dynamics of blood glucose and SGLTs in SDT fatty rats with obese type 2 DM (leptin receptor mutation), which is hyperglycemic from an early stage. Method 24 male SDT fatty rats were divided into four groups: sham + placebo group (n=6); sham + dapagliflozin (dapa, 1.5 mg/kg/day) group (n=6); UNx + placebo group (n=6); UNx + dapa group (n=6). UNx or sham operations were undergone at week 6. Measurements included body weight, food intake, water consumption, urine output, blood pressure, serum creatinine, and blood glucose in the experiment. At week 12, the rats were sacrificed, and the kidneys were sampled to measure SGLT1 and SGLT2 mRNA in the renal cortex by real-time PCR quantification. Results Blood glucose levels continued to rise from week 7 in the sham + placebo group, but the rate of increase was still slower in the UNx + placebo group, and the increase in blood glucose levels was mostly suppressed with dapa administration (Fig. 1). Only the Sham + placebo group showed increased urinary volume and weight loss after week 10 due to hyperglycemia. There were no significant differences in serum creatinine or blood pressure during the study. Real-time PCR results showed that SGLT2 mRNA in the renal cortex was significantly decreased by 26% in the UNx group (P=0.0386), but SGLT1 mRNA was not significantly different. Conclusion Uninephrectomized diabetic rats delayed onset of hyperglycemia and reduced SGLT2 mRNA; SGLT2 inhibitor treatment further delayed the onset of hyperglycemia but did not alter SGLT2 mRNA expression. In animal models of diabetes, renal glucose reabsorption appeared to be a major contributor to the development of hyperglycemia.

#2919 Renal functional reserve assessment in patients with coronary microvascular dysfunction and preserved renal function—experience of a center

Abstract Background and Aims Renal Functional Reserve (RFR) is a field of scientific debate and may be a valuable diagnostic tool for the early detection of subclinical renal disease. According to literature, chronic kidney disease is related to cardiovascular disease (CVD), however the available data on the association of early renal dysfunction and CVD are sparse. The aim of the present study is to evaluate RFR in patients with coronary microvascular dysfunction (CMD) and preserved renal function [eGFR≥ 60 ml/min/1.73 m2 (CKD-EPI) and proteinuria&amp;lt; 400 mg/24 h]. Method This is a single-center, prospective study enrolling patients with INOCA. We are presenting preliminary results. In the absence of significant coronary artery stenosis, functional coronary circulation assessment was performed for all patients and we estimated coronary flow reserve (CFR) and index of microvascular resistance (IMR). In all participants, RFR was estimated by endogenous creatinine clearance after oral protein load (cooked meal, 1.2 gr/kg). Normal RFR was defined as ≥30 ml/min/1.73 m2. Also, patients with INOCA were offered 24-hour Ambulatory Blood Pressure Monitoring (ABPM). Results A total of 22 participants have been enrolled so far in study: 10 without CMD—control group [7 female, mean age: 54.4 ± 8.1 years) and 12 with INOCA—CMD group (9 female, 75%, mean age: 53.5 ± 10.3 years). CMD patients were classified into 2 groups, structural and functional endotype (CFR&amp;lt;2.5 and an IMR≥25 were considered abnormal). The RFR value for CMD group is 7.4 ± 6.3 ml/min/1.73 m2, while for non-CMD group 36.3 ± 5.8 ml/min/1.73 m2 (p &amp;lt; 0.005), relationship that remained statistically significant after controlling for confounding factors. Regarding the two endotypes of MVD, it was found that RFR for the patients with the functional endotype is 3.5 ± 2.4 ml/min/1.73 m2, while for those with the structural endotype 9.3 ± 6.9 ml/min/1.73 m2 (p-value = 0.061). Furthermore, no statistically significant relationship emerged between RFR and IMR, CFR indices (p = 0.347, p = 0.263). According to data from 24 hr ABPM, there were no significant differences in ambulatory blood pressure (systolic and diastolic) between the two endotypes of CMD (p = 0.594, p = 0.243), as well as no relationship with RFR (p = 0.553, p = 0.594). However, the proportion of non-dippers (for both SBP and DBP) was significantly higher in functional CMD endotype (p &amp;lt; 0.05). It was not found correlation between RFR and non-dipping phenotype, both for SBP and DBP (p = 0.561, p = 0.238). Conclusion Abnormal RFR has been observed in all patients with microvascular dysfunction. In addition, patients with functional CMD show a lower RFR value compared to those with structural. RFR is not related to blood pressure or the non-dipping pattern. Given the hypothesis that the assessment of renal functional reserve is an early diagnostic tool for subclinical renal disease, the early identification of patients with specific phenotypes—such as INOCA and pathological RFR—could contribute to the individualization of therapeutic interventions.

Prediction of Visual Outcome After Rhegmatogenous Retinal Detachment Surgery Using Artificial Intelligence Techniques.

This study aimed to develop artificial intelligence models for predicting postoperative functional outcomes in patients with rhegmatogenous retinal detachment (RRD). A retrospective review and data extraction were conducted on 184 patients diagnosed with RRD who underwent pars plana vitrectomy (PPV) and gas tamponade. The primary outcome was the best-corrected visual acuity (BCVA) at three months after the surgery. Those with a BCVA of less than 6/18 Snellen acuity were classified into a vision impairment group. A deep learning model was developed using presurgical predictors, including ultra-widefield fundus images, structural optical coherence tomography (OCT) images of the macular region, age, gender, and preoperative BCVA. A fusion method was used to capture the interaction between different modalities during model construction. Among the participants, 74 (40%) still had vision impairment after the treatment. There were significant differences in age, gender, presurgical BCVA, intraocular pressure, macular detachment, and extension of retinal detachment between the vision impairment and vision non-impairment groups. The multimodal fusion model achieved a mean area under the curve (AUC) of 0.91, with a mean accuracy of 0.86, sensitivity of 0.94, and specificity of 0.80. Heatmaps revealed that the macular involvement was the most active area, as observed in both the OCT and ultra-widefield images. This pilot study demonstrates that artificial intelligence techniques can achieve a high AUC for predicting functional outcomes after RRD surgery, even with a small sample size. Machine learning methods identified The macular region as the most active region. Multimodal fusion models have the potential to assist clinicians in predicting postoperative visual outcomes prior to undergoing PPV.

Clinical study on the efficacy and safety of glaucoma drainage implants in the treatment of different types of glaucoma

Objective: To evaluate the efficacy and safety of glaucoma drainage implants(XEN-45 Gel Stent) for glaucoma treatment. Methods: A prospective study was conducted to continuously collect the clinical data of patients who were diagnosed with glaucoma and underwent XEN-45 Gel Stent implantation in the Ophthalmology Department of Peking University People's Hospital from January 2022 to August 2023. The visual acuity, intraocular pressure, number of glaucoma medications, and success rate of the patients were analyzed before and after surgery at 1 day, 1 week, 1 month, 3 months, 6 months, 12 months, and 18 months. The differences in intraocular pressure and number of glaucoma medications among primary open-angle glaucoma, primary angle closure glaucoma, secondary glaucoma, and different implantation methods of XEN-45 Gel Stent among patients with primary open-angle glaucoma were compared. The intraoperative and postoperative complications were observed, and the risk factors for needling and surgical complete success were analyzed. Results: A total of 48 eyes from 48 patients were included in this study, comprising 27 males and 21 females, with a mean age of (54.4±18.0) years and the disease duration was 36.0(7.3, 81.0) months.There were 28 cases of primary open-angle glaucoma, 4 cases of primary angle closure glaucoma, and 16 cases of secondary glaucoma.The follow-up period was 8.0 (3.0, 12.0) months. At 12 months after surgery, the intraocular pressure decreased from 20.5 (17.0, 26.0) mmHg to (13.5±3.3) mmHg (P<0.05), and the number of glaucoma medications decreased from 3.0 (3.0, 4.0) to 0.0 (0.0, 0.0) (P<0.05). The complete success rate and qualified success rate were 73.9% (17/23) and 91.3% (21/23), respectively. The most common postoperative complications were shallow anterior chamber in 6 cases (12.5%), hypotony in 3 cases (6.3%), and blocked stent in 3 cases (6.3%). The most common postoperative treatment was needling in 27 cases (56.3%). There was no significant difference in intraocular pressure among different types of glaucoma. In the comparison of postoperative effects of different surgical implantation methods for primary open-angle glaucoma, there were no statistically significant differences in intraocular pressure and the number of glaucoma medications at other follow-up time points except 1 month after surgery (P<0.05). Univariate logistic regression analysis did not find any risk factors associated with needling and surgical complete success. Conclusions: XEN-45 Gel Stent implantation is an effective and safe surgical option for different types of glaucoma patients in China, which can significantly reduce intraocular pressure and the use of glaucoma medications and has a high success rate. However, some patients may need needling or other treatments after surgery.

Renal functional reserve assessment in patients with coronary microvascular dysfuntion and preserved renal function

Abstract Funding Acknowledgements None. Introduction Renal Functional Reserve (RFR) is a field of scientific debate and may be a valuable diagnostic tool for the early detection of subclinical renal disease. According to literature, chronic kidney disease is related to cardiovascular disease (CVD), however the available data on the association of early renal dysfunction and CVD are sparse. Aim The aim of the present study is to evaluate RFR in patients with coronary microvascular dysfunction (CMD) and preserved renal function [eGFR≥ 60 ml/min/1.73m2 (CKD-EPI) and proteinuria&amp;lt; 400mg/24h]. Methods This is a single-center, prospective study enrolling patients with CMD. We are presenting preliminary resuts. In the absence of significant coronary artery stenosis, functional coronary circulation assessment was performed for all patients. Coronary flow reserve (CFR) and index of microvascular resistance (IMR) were measured invasively. In all participants, RFR was estimated by endogenous creatinine clearance after oral protein load (cooked meal, 1.2gr/kg). Normal RFR was defined as ≥30 ml/min/1.73m2. Also, patients with CMD were offered 24-hour Ambulatory Blood Pressure Monitoring (ABPM). Results A total of 25 participants have been enrolled so far in study: 11 without CMD - non-CMD group [7 female, 64%, mean age: 52.9±8.8 years) and 14 with INOCA – CMD group (11 female, 79%, mean age : 53.5±10.3 years). CMD patients were classified into 2 groups, structural and functional endotype (CFR&amp;lt;2.5 and IMR≥25 were considered abnormal). The RFR value for CMD group is 7.4±6.3 ml/min/1.73m2, while for control group 36.3±5.8 ml/min/1.73m2 (p&amp;lt;0.005), This difference between groups was found to be statistically significant after controlling for confounding factors. It was found that RFR value for functional CMD endotype was 3.8±2.6 ml/min/1.73m2, while for patients with structural endotype 9.6±7,2 ml/min/1.73m2 (p=0.06). Furthermore, no statistical significance was found between RFR and IMR, CFR indices (p =0.35, p =0.23 respectively). According to data from 24hr ABPM , there were no significant differences in ambulatory blood pressure (systolic and diastolic) between the two endotypes of CMD (p=NS for all), as well as no relationship with RFR (p=0.6, p=0.6 respectively) was observed. However, the proportion of non-dippers (for both SBP and DBP) was significantly higher in functional CMD endotype (p&amp;lt;0.05). It was not found correlation between RFR and non-dipping phenotype, for both SBP and DBP (p=NS). Conclusion Abnormal RFR has been observed in all patients with microvascular dysfunction. In addition, patients with functional CMD show a lower RFR value compared to those with structural. RFR is not related to levels of BP or the non-dipping pattern. Given the hypothesis that the assessment of renal functional reserve is an early diagnostic tool for subclinical renal disease, the early identification of patients with specific phenotypes could contribute to the individualization of therapeutic interventions.

The impact of yoga in pregnancy on placental growth factor levels and mean arterial pressure in pre-eclampsia: A randomized controlled trial

Context: Pre-eclampsia is a pregnancy-related condition characterized by hypertension, proteinuria, and edema occurring after 20 weeks of pregnancy or during the postpartum period. Several markers are often assessed to determine the suitable option for confirming pre-eclampsia diagnosis, one of which is the examination of placental growth factor (PlGF) as a placental ischemia indicator. Aims: To evaluate the impact of prenatal yoga on PlGF and mean arterial pressure (MAP) levels in pre-eclampsia within the Madura region. Methods: A randomized controlled trial was conducted on fifty subjects that were randomly allocated to the experimental group with pre-post control groups consisting of 50 participants, namely 25 pregnant women with pre-eclampsia and 25 healthy individuals. The selection was conducted based on the following inclusion criteria: belonging to Madura ethnicity spanning three generations, exhibiting pregnancy duration &gt;20 weeks, maternal ages ranging from 20–35 years, pre-pregnancy body mass index (BMI) &gt;25, a history of hypertension, diabetes mellitus (DM), kidney disorders, pre-eclampsia, chronic hypertension, or family history of chronic high blood pressure and pre-eclampsia among those at risk. PlGF levels were estimated using an ELISA kit, while blood pressure was measured with an Omron brand sphygmomanometer. Results: Statistical analysis performed with the Wilcoxon sign test and T-test indicated significant differences (p&lt;0.005) in systolic blood pressure, diastolic blood pressure, and MAP between the groups. Furthermore, a significant difference was observed in PlGF levels before and after engaging in prenatal yoga practice (p&lt;0.05). Conclusions: The results showed that prenatal yoga contributed to the elevation of PlGF levels in women with pre-eclampsia, compared to their healthy counterparts.