Various Parameters In Patients Research Articles

Demographic analysis of hearing impairment based on various parameters in patients with cochlear implant.

To analyse the demographic and clinical variables in children having undergone cochlear implant surgery because of deafness. The cross-sectional study was conducted from January to November 2022 at the Centre for Research in Experimental and Applied Medicine laboratory of the Department of Biochemistry and Molecular Biology, Army Medical College, Rawalpindi, Pakistan, in collaboration with the Ear, Nose and Throat Department of Combined Military Hospital, Rawalpindi, and comprised children of eith gender aged up to 10 years who had received cochlear implant. Data was collected through questionnaire-based detailed interviews. Syndromic Hearing Loss, Non-Syndromic Hearing Loss, and Acquired Hearing Loss were identified among the subjects. Data was analysed using SPSS 22. Of the 250 cases, 147(58.8%) were boys, 146(58.4%) were aged 0-5 years, 219(87.6%) had prelingual onset of disease, and 202(80.8%) had a non-progressive disease course. In 203(81.2%) cases, normal developmental milestones were seen. Parental consanguinity was observed in 219(87.6%) cases. However, 63(25.2%) patients had a first-degree relative who had a history of deafness. In 170(68%) cases, hearing loss was hereditary, whereas in 80(32%) it was acquired. Meningitis was the most commonly identified risk factor 55(68.75%). Acquired risk factors and family history had significant association with hearing loss (p<0.05). Speech perception significantly improved in all 219(100%) patients with prelingual hearing loss who underwent cochlear implantation. Majority of the cases were found to be male, had a prelingual disease onset and a non-progressive disease course. Family history was a significant factor, while meningitis was the most common acquired cause of hearing loss.

Effect of vitamin D supplementation on various parameters in patients with non-alcoholic fatty liver disease: An updated meta-analysis.

The current updated meta-analysis aimed to explore the effects of vitamin D supplementation on various parameters in patients with non-alcoholic fatty liver disease (NAFLD), using the latest trials available. PubMed, Embase, and the Cochrane Library were screened for the collection of randomized controlled trials (RCTs) that compared the efficacy of additional vitamin D vs. the placebo group on NAFLD patients in the last 5 years. Trials included were focused on the assessment of anthropometric and biochemical indices. Our results revealed that additional vitamin D greatly increased serum 25-hydroxyvitamin D (25(OH)D), and decreased the low-density lipoprotein-cholesterol (LDL-C) levels. However, no significant differences were found in terms of triglyceride (TG), total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), c-glutamyltransferase, fasting blood glucose (FBG), homeostasis model assessment of insulin resistance (HOMA-IR) and Ca2+ levels between the supplementation of vitamin D and placebo. The present study demonstrated the advantageous impact of supplementary vitamin D on the levels of 25(OH)D and LDL-C in NAFLD patients. However, the results failed to provide evidence for the superiority of additional vitamin D in relation to the concentrations of serum ALP, AST, TC, Ca, γ-glutamyl transferase (GGT), TC, FBG, IR and HDL-C.

Analysis of various health parameters for early and efficient prediction of sepsis

Sepsis is a major health issue causing mortality, morbidity and health care financial crisis to people around the globe. To resolve this issue, many researchers and clinical practitioners have worked hard to predict the onset of sepsis using various parameters of patients. The proposed work is an attempt of authors to analyse the various parameters (8 vital parameters, 26 laboratory or clinical parameters, and 6 demographic parameters regarding hospital stay) given in Physionet Challenge dataset so as to devise the best features for early and efficient prediction of sepsis. Authors have also addressed another important issue of missing values of some parameters of some patients by applying Gaussian Mixture Model to estimate the missing value in pre-processing steps. The pre-processed data is then fed to Extreme Gradient Boosting algorithm (XGBoost), which is a state of the art performer algorithm for prediction purposes in data analysis field. The experimental results show that by real time monitoring of data from cloud, sepsis can be predicted 6 hours prior to the onset of sepsis with an accuracy score of 0.994 and AUC score of 0.867. It is also observed that demographic parameters play a vital role in sepsis prediction. The Since the parameters used for early prediction can be easily acquired with the help of sensors, the proposed approach proves its potential for development of mobile and website applications for patient monitoring, real-time prediction of sepsis and generation of appropriate alert system.

A HOSPITAL BASED COMPARATIVE STUDY OF SERUM MEAN PLATELET VOLUME IN ISCHEMIC STROKE PATIENTS.

Objectives: This study was evaluated the association of serum means platelet volume, functional outcome and various parameters in patients of ischemic stroke.&#x0D; Methods: Detail history clinical examinations and relevant investigations were performed to all subjects. Lab parameters included as platelets counts, mean platelet volume and others were performed. The diagnosis of ischaemic stroke was made clinically with the evidence of acute lesions (infarct) confirmed by brain CT or MRI within the first 24 h of presentation of symptoms. Each patient condition was assessed by modified Rankin Scale.&#x0D; Results: Data was analyzed using SPSS version 26 software. Related-Samples Wilcoxon Signed Rank Test was applied. Mean and standard deviation were calculated. P value was taken less than or equal to 0.05 for significant differences (p ≤ 0.05). Conclusions: There was no significant difference seen in platelet count of ischemic stroke cases with control. Mean platelet volume was significantly higher in ischemic stroke cases than normal subjects. Majorities of ischemic stroke cases had moderate disability, required some help but able to walk without assistance. MPV was higher in ischemic stroke cases that had higher Modified Rankin scale. Hence, serum MPV can be used as meaningful laboratory findings for early detection of ischemic stroke.&#x0D; Key words: Ischemic stroke, mean platelet volume, platelet count, modified Rankin score

Factors associated with carotid intima-media thickness in patients on maintenance hemodialysis.

PurposeThe aim of this study was to analyze the association of the carotid intima-media thickness (CIMT) with various parameters in patients on maintenance hemodialysis (mHD).MethodsA cross-sectional study was conducted, enrolling 68 subjects (41 men, 27 women) on mHD in the Hemodialysis Unit, Sanglah Hospital, Denpasar, Indonesia. CIMT was measured with B-mode ultrasonography using a USG Sonoace 8000 and a 7.5 MHz linear transducer.ResultsCIMT was higher in subjects with cardiovascular disease (CVD) compared with those without CVD (0.6494 vs 0.7288 mm; P=0.026), and in men compared with women (0.7056 vs 0.6141 mm; P=0.003). CIMT was correlated with age (R=0.607; P<0.001), plasma albumin (R=−0.291, P=0.016), serum phosphate (R=−0.294, P=0.015), calcium-phosphate product (R=−0.284, P=0.011), and plasma high-sensitivity C-reactive protein (R=0.279, P=0.030). However, after multiple linear regression testing, only age consistently had a role in determining the CIMT value (β=0.452, P<0.001).ConclusionSubjects with CVD have higher CIMT than those without CVD and men had higher CIMT than women. In addition, older age, higher high-sensitivity C-reactive protein, and lower albumin, phosphate, and calcium-phosphate product levels were correlated with higher CIMT. Age was the most important marker for CIMT in subjects on mHD.

Heterotopic ossification in patients previously hospitalized in an intensive care unit.

Heterotopic ossification (HO) is a potential complication in patients hospitalized in an intensive care unit (ICU). In this study we examined the association of HO diagnosed with three-phase bone scan (3pBS) in association with various parameters in patients previously hospitalized in ICU. We retrieved patient records of the last 12 years subjected to 3pBS and diagnosed with HO from the Department of Nuclear Medicine (2004 up to 2016) and searched for a name match from ICU records. We found 61 patients that had a positive 3pBS for HO of whom 17 patients were hospitalized in the ICU. Among the 17 patients, twelve fulfilled the study criteria and were included in the study. The mean age was 38 years and 92% were males. HO was unilateral in 7 and bilateral in 5 patients. Patients with unilateral HO had up to 2 joints with HO, while those with bilateral had up to 4 joints. HO was most frequently observed in lower limbs, with hip being the most common joint affected. In the upper limbs, HO occurred predominantly in bilateral joints with elbow being the most frequently involved joint. Patients with longer duration of ICU stay had more joints affected. HO is a potential complication in patients with ICU hospitalization. Since 3pBS is an imaging method for early detection of HO, patients hospitalized in ICU should be screened with 3pBS for appropriate management.

High Prevalence of Distress among Patients with Type 2 Diabetes (T2DM)—A Hospital-Based, Cross-Sectional Study from South India

Background: Diabetes distress (DD) refers to unique, often hidden emotional burdens and worries, distinct from clinical depression, that are part of the spectrum of patient experience when managing diabetes. Aim: To assess DD and its association with various parameters in patients with T2DM. Methodology: A cross sectional study was done on 262 out-patients with T2DM in a multispecialty hospital in South India. DD was measured by DDS-17, a 17-item self-reported DD scale used with subscales in 4 domains - Emotional burden (EB), Physician, Regimen and Interpersonal distress. Overall score &amp;lt; 2.0 was little or no distress, 2.0-2.9 moderate, ≥3.0 was high distress. Data was analysed using SPSS version 11.5. Results: Mean age of participants was 59.7 ± 9.1 years. Females constituted 71.8%. BMI was ≤ 25kg/m2 in 32.8%. Duration of diabetes was &amp;lt; 10 years in 42%. Insulin was used by 45%. Mean HbA1c was 8.7±1.7%. Prevalence of DD was 27.9%, with moderate distress in 22.1% and high distress in 5.7%. Mean total DD score was 1.67± 0.59. Mean for EB, physician-related, regimen-related and interpersonal distress were (2.1 ± 1.02), (1.09 ± 0.33), (1.92 ± 0.89), (1.30± 0.76) respectively. Total DD had significant association with BMI (p=0.04), duration of T2DM (p=0.04), HbA1c (p=0.01), neuropathy (p=0.002) and nephropathy (p=0.008). EB, considered most important domain, was associated with duration of T2DM (p=0.02), insulin use (p=0.002), neuropathy (p&amp;lt;0.001), nephropathy (p=0.008), high HbA1c levels (p=0.001), ASCVD in females (p&amp;lt;0.001). Regimen related distress was more in those with high HbA1c (p=0.001) and smokers (p=0.04). Discussion: The study, first of its kind from South India, identifies high prevalence of DD in this population Assessment of DD should be integrated into patients’ self-care plan. Patients become more involved in managing diabetes if their specific emotional distress are taken care of, and have a better sense of social care, health control and self-efficacy. Disclosure P. Sankar: None. P. Sasikumar: None. R. Medayil: None. R. Jacob: None. S. Sasidharan: None.

High Prevalence of Distress among Patients with Type 2 Diabetes (T2DM)—A Hospital-Based Cross-Sectional Study from South India

Background: Diabetes distress (DD) refers to unique, often hidden emotional burdens and worries, distinct from clinical depression, that are part of the spectrum of patient experience when managing diabetes. Aim: To assess DD and its association with various parameters in patients with T2DM. Methodology: A cross sectional study was done on 262 out-patients with T2DM in a multispecialty hospital in South India. DD was measured by DDS-17, a 17-item self-reported DD scale used with subscales in 4 domains - Emotional burden (EB), Physician, Regimen and Interpersonal distress. Overall score &amp;lt;2.0 was little or no distress, 2.0-2.9 moderate, ≥3.0 was high distress. Data was analysed using SPSS version 11.5. Results: Mean age of participants was 59.7 ± 9.1 years. Females constituted 71.8%. BMI was ≤ 25kg/m2 in 32.8%. Duration of diabetes was &amp;lt;10 years in 42%. Insulin was used by 45%. Mean HbA1c was 8.7±1.7%. Prevalence of DD was 27.9%, with moderate distress in 22.1% and high distress in 5.7%. Mean total DD score was 1.67± 0.59. Mean for EB, physician-related, regimen-related and interpersonal distress were (2.1 ± 1.02), (1.09 ± 0.33), (1.92 ± 0.89), (1.30± 0.76) respectively. Total DD had significant association with BMI (p=0.04), duration of T2DM (p=0.04), HbA1c (p=0.01), neuropathy (p=0.002) and nephropathy (p=0.008). EB, considered most important domain, was associated with duration of T2DM (p=0.02), insulin use (p=0.002), neuropathy (p&amp;lt;0.001), nephropathy (p=0.008), high HbA1c levels (p=0.001), ASCVD in females (p&amp;lt;0.001). Regimen related distress was more in those with high HbA1c (p=0.001) and smokers (p=0.04). Discussion: The study, first of its kind from South India, identifies high prevalence of DD in this population. Assessment of DD should be integrated into patients’ self-care plan. Patients become more involved in managing diabetes if their specific emotional distress are taken care of, and have a better sense of social care, health control and self-efficacy. Disclosure P. Sankar: None. P. Sasikumar: None. R. Medayil: None. R. Jacob: None. S. Sasidharan: None.

Impact of CyberKnife Radiosurgery on Median Overall Survival of Various Parameters in Patients with 1-12 Brain Metastases.

IntroductionThis study’s objective is to assess various patient, tumor and imaging characteristics and to compare median overall survival (OS) of 150 patients with 1-12 brain metastases post-CyberKnife radiosurgery (CKRS) (Accuray, Sunnyvale, California) alone.MethodsCharts of 150 patients, from 2009-2014, treated with only CKRS for brain metastases were reviewed retrospectively for patient, tumor, and imaging characteristics. Parameters included demographics, Eastern Cooperative Oncology Group (ECOG) performance scores, number and control of extracranial disease (ECD) sites, cause of death (COD), histology, tumor volume (TV), and post-CKRS whole brain radiotherapy (WBRT). The imaging characteristics assessed were time of complete response (CR), partial response (PR), stable imaging or local failure (LF), and distal brain failure (DBF). The primary tumor Ki-67s of the breast carcinoma brain metastasis patients, who had the longest median OS of any group, were recorded when available.ResultsThe predominant age group for the 150-patient cohort was the younger 17-65 years of age category, which was represented by 94 (62.7%). The 150-patient group had slightly more males, 79 (52.7%). The majority of 111 (74%) patients had an ECOG score of 1, 39 (26%) had 1 ECD site and uncontrolled ECD occurred in 112 (74.7%). The main COD was ECD in 106 (70.7%). The prevalent tumor histology was non-small cell lung carcinoma (88 of 150, 58.7%). The most common TV was 0-0.5 ccs (48 of 150, 32%). The majority of 125 (83.3%) patients did not undergo post-CKRS WBRT. Imaging outcomes were local control (LC) (CR, PR, or stable imaging) in 119 (79.3%), of whom 38 (25.3%) had CR, 56 (37.3%) PR and 25 (16.7%) stable imaging; LF was the outcome in 31 (20.7%) and DBF occured in 83 (55.3%). The median OS was 13 months. Patients 17-65 years of age had a median OS of 13 months, while those 66-88 years, had 12 months. Females versus males had median OS of 15 versus 12 months. The most prolonged median OS of 21.5 months occurred in those with an ECOG score of 0. Patients with two ECD sites had a median OS of 14.5 months, while those with controlled ECD, 20.5 months. Patients with breast cancer brain metastases had the longest median OS of 23 months. The median OS for each of three (0-0.5 ccs, 0.6-1.5 ccs, 1.6-4.0 ccs) of four CKRS TV quartiles was 13 months and for those with 4.1-28.5 ccs, 10 months. Median OS for patients with versus without post-CKRS WBRT was 23 versus 12 months. The longest median OS of 18.5 months for post-CKRS imaging outcomes was in patients with CR; those with LF had a median OS of 11.5 months. Of nine patients with breast carcinoma brain metastases with available Ki-67s from primary tumor resections, the Ki-67 values were ≥ 34% for four patients with CR, PR and stable imaging outcomes, and < 34% for five patients with LF.ConclusionsAn ECOG score of 0, ECD control, breast carcinoma brain metastasis histology. undergoing WBRT post-CKRS and CR imaging outcomes, each resulted in a longer median OS. The Ki-67 proliferation indices from primary breast carcinoma resection correlated well with the brain imaging outcomes in a small preliminary study in the present study's breast carcinoma patients with brain metastases.

Impact of CyberKnife Radiosurgery on Overall Survival and Various Parameters of Patients with 1-3 versus ≥ 4 Brain Metastases.

IntroductionThis study’s objective is to compare the overall survivals (OSs) and various parameters of patients with 1-3 versus ≥ 4 brain metastases post-CyberKnife radiosurgery (CKRS) (Accuray, Sunnyvale, California) alone.MethodsCharts of 150 patients, from 2009-2014, treated with only CKRS for brain metastases were reviewed retrospectively for overall survival (OS) and patient, tumor, and imaging characteristics. Parameters included demographics, Eastern Cooperative Oncology Group (ECOG) performance scores, number and control of extracranial disease (ECD) sites, cause of death (COD), histology, tumor volume (TV), and post-CKRS whole brain radiotherapy (WBRT). The imaging characteristics assessed were time of complete response (CR), partial response (PR), stable imaging or local failure (LF), and distal brain failure (DBF). Patients and their data were divided into those with 1-3 (group 1) versus ≥ 4 brain metastases (group 2). For each CR and LF patient, absolute neutrophil count (ANC), absolute lymphocyte count (ALC)), and ANC/ALC ratio (NLR) were obtained, when available, at the time of CKRS.ResultsBoth group 1 and group 2 had a median OS of 13 months. The patient median age for the 115 group 1 patients versus the 35 group 2 patients was 62 versus 56 years. Group 1 had slightly more males and group 2, females. The predominant ECOG score for each group was 1 and the number of ECD sites was one and two, respectively. Uncontrolled ECD occurred in the majority of both group 1 and group 2 patients. The main COD was ECD in both groups. The prevalent tumor histology for groups 1 and 2 was non-small cell lung carcinoma. Median TVs were 1.08 cc versus 1.42 cc for groups 1 and 2, respectively. The majority of patients in both groups did not undergo post-CKRS WBRT. Imaging outcomes were LC (CR, PR, or stable imaging) in 93 (80.9%) and 26 (74.3%) group 1 and 2 patients, of whom 32 (27.8%) and six (17.1%) had CR; 38 (33.0%) and 18 (51.4%), PR and 23 (20.0%) and two (5.7%), stable imaging; LF was the outcome in 22 (19.1%) and nine (25.7%) patients, and DBF occurred in 62 (53.9%) and 21 (60.0%), respectively. Uni- and multivariable analyses showed the independent parameters of a lower ECOG score, a greater number of ECD sites and uncontrolled ECD were significantly associated with greater mortality risk with and without accounting for other covariates. At CKRS, 19 group 1 and 2 CR patients had a mean ANC of 5.88 K/µL and a mean ALC of 1.31 K/µL and 13 (68%) of 19 had NLRs ≤ five, while 11 with LFs had a mean ANC of 5.22 K/µL and a mean ALC of 0.93 K/µL and seven (64%) had NLRs > five. An NLR ≤ five and high ALC was associated with a CR and an NLR > five and a low ALC with an LF.ConclusionsMedian OS post-CKRS was 13 months for both patients with 1-3 brain metastases and with ≥ 4. This is the only study in the literature to evaluate OS in patients with 1-3 and ≥ 4 brain metastases who were treated with CKRS alone. For groups 1 and 2 patients combined, 119 (79.3%) had LC and 38 (25.3%) had CR. The ANC, ALC, and NLR values are likely predictive of CR and LF outcomes

Circulating SerpinB1 levels and clinical features in patients with type 2 diabetes

ObjectiveThe main purpose of this study was to investigate the association of serum SerpinB1 levels and various parameters in patients with type 2 diabetes. The effect of canagliflozin (a sodium...

Fast, Intelligent and Secure an Embedded Health-care Supervisory System

&lt;p class="IEEEAbtract"&gt;The world of medical supervisory system should remotely monitor various parameters of patients with help of electronics. This work aims at monitoring parameters in fast, intelligent and secure way. The work emphasizes on designing an embedded system which handles critical parameters of patients in hospital/nursing units. The data samples are processed using an ARM based CPU’s and to achieve performance metrics TI RTOS is used and validated. The system generates interrupts based on the priority of each of critical parameters with a threshold in it and enables alarming/warning system. The data is then transferred to IoT layer using a CC3100 TI based SoC for further reference and processing.&lt;/p&gt;In this paper, 4 parameters has been monitored for designing system such as measuring Respiratory rate for human breath, MMG signal for muscle movement, Blood pressure rate as well as Temperature. RTOS helps with scheduling as well as with interrupts also helps Wi-Fi module to work with it. Wi-Fi module provides many security options as WEP, WAP, and WAP2.

Surgical Scar Site Recurrence in Patients With Cervical Cancer on 18F-FDG PET-CT: A Case-Control Study.

The purpose of this study was to assess the role of fluorine 18 ((18)F)-fluorodeoxyglucose positron emission tomography-computed tomography ((18)F-FDG PET-CT) in evaluating various parameters in patients with surgical scar site recurrence in cervical carcinoma. Data of all patients with cervical cancer (n = 329) who underwent PET-CT at our institute between 2005 and 2013 was reviewed. Of these 329 patients, 132 patients who were surgically treated and underwent restaging/follow-up PET-CT were included in the present study for final analysis. Tumor recurrence at the abdominal surgical scar site was looked for. Abnormal uptakes suggestive of active disease at other sites were also noted. Maximum standardized uptake value was measured for all the lesions. Patients with scar site recurrence were taken as cases (n = 6), whereas the remaining patients served as controls (n = 126). Comparison with conventional imaging modalities was made wherever available. Histopathological examination was always sought for. The incidence of scar site recurrence after surgery was found to be 4.5% (6/117). A total of 56 of 132 patients had recurrent disease, including 6 patients with scar site recurrence. All of the patients with scar site recurrence also had recurrent disease at other sites (local, nodal, or distant). Conventional imaging modalities were available in 4 of these 6 patients and detected scar site recurrence in 3 of those 4 patients. In patients with scar site recurrence, the mean ± SD time to scar site recurrence was 14.0 ± 10.9 months (median, 10 months; range, 7-36 months). Significant difference was seen between cases and control for International Federation of Genecology and Oncology stage (P = 0.001) and nodal recurrence (P = 0.007). Additionally, age, nodal recurrence, distant recurrence, and scar site recurrence were significantly associated with death. Scar site recurrence carries a poor prognosis, and the incidence is much higher than previously known when PET-CT is used as a modality for its detection.

Effect of phacoemulsification surgery on various parameters in patients with glaucoma.

Cataract and glaucoma are both common conditions and are often present in the same patient. The incidence of these diseases increases with age. Besides vision impairment, these diseases are associated with decrement in quality of life (QOL). To study the effect of phacoemulsification surgery on various parameters in patients with glaucoma. We enrolled 50 eyes of 36 patients with glaucoma and concomitant cataract scheduled for phacoemulsification cataract surgery . A record was made which included number of anti-glaucoma medications, visual acuity (VA), intra-ocular pressure (IOP), anterior chamber depth (ACD), cataract category/grade, visual field (VF) analysis (mean deviation (MD) and pattern standard deviation (PSD) and responses to Indian visual function questionnaires (IND-VFQ). The patients were re-evaluated at one month after cataract extraction and the above parameters were again obtained to compare them with the firs values. The mean age of the patients was 66.34 yrs ± 7.96; 10 eyes (20 %) had angle closure and 40 (80 %) had open angle glaucoma. Following cataract extraction, VA improved, IOP decreased, number of glaucoma medications decreased and AC depth increased. The VF analysis showed that the improvement in MD was significant while changes in PSD were not. The improvements seen in the visual function questionnaires (VFQ) were significant. When these parameters were analyzed based on the types of glaucoma, in the angle closure glaucoma (ACG) group, the decrease of IOP from 15.30 ± 6.18 to 12.70 ± 2.71 was not significant ( p = 0.24). In the open angle glaucoma (OAG) group, the changes in the number of anti-glaucoma medication were not significant. When the parameters were analyzed in subgroups, based on cataract category, nuclear sclerosis and posterior sub-capsular, the VA improved significantly in both and the MD improved in the posterior sub-capsular surgery. Improvement in VFQ's was observed in denser nuclear sclerotic and posterior subcapsular cataracts. Cataract extraction results in significant improvement in vision, IOP reduction, decrease in the number of medications, deepening of AC and in the quality of life in patients with co-existing glaucoma when the cataract is of significant density.

Effects of proton pump inhibitors on lung cancer precise radiotherapy-induced radiation pneumonitis.

The objective of this study was to explore the effects of proton pump inhibitors (PPIs) on the development and prognosis of lung cancer precise radiotherapy-induced radiation pneumonitis. Clinical materials of 84 lung cancer patients who had radiation pneumonitis after precise radiotherapy were retrospectively analyzed, and the patients were divided into PPI group and control group, according to whether or not PPIs were applied. The development and prognosis of patients and the effects of different doses of PPI on patient condition from two groups were compared. There were 57 PPI cases in PPI group and 27 cases in control group. Basic characteristics of patients were not statistically different between the two groups; however, white blood cell count, oxygenation indexes, blood gas pH, and lung imaging index were significantly different (p < 0.05), indicating that radiation pneumonitis tended to be more severe in PPI group. As regards effects of PPI on prognosis of two groups, remission rate of radiation pneumonia in PPI group was significantly less than that of the control group. Among 57 cases in PPI group, there were 31 patients applied with PPI ≤ 1DDD and 31 patients applied with PPI > 1DDD. In comparison of the various parameters of patients, 7 days after being applied with different doses of PPI, there were no significant differences between the parameters of radiation pneumonitis. PPIs should be cautiously utilized to avoid the effects of lung cancer radiotherapy-induced radiation pneumonia.

AB0437 Clinical meaning of simultaneous normal CRP and elevated ESR in patients with rheumatoid arthritis

BackgroundWe have often found that markers of inflammation such as elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) do not match in the routine clinical management of rheumatoid arthritis...

Influence of heart failure etiology on the effect of upgrading from right ventricular apical to biventricular or bifocal pacing in patients with permanent atrial fibrillation and advanced heart failure

Chronic heart failure (HF) results from various disease processes. There are no data on the effect of the etiology of HF on the improvement after pacemaker upgrade. OBJECTIVES The aim of the study was to assess changes in various parameters in patients with ischemic (IC) and nonischemic (NIC) cardiomyopathy after pacemaker upgrade in pacemaker-dependent patients with permanent atrial fibrillation, in the course of advanced HF during 12-month follow-up. The study involved 34 patients who underwent an upgrade from right ventricular apical to biventricular or bifocal right ventricular pacing. In each patient, 12-lead electrocardiography, transthoracic echocardiography, 6-minute walking test, and the measurement of brain natriuretic peptide levels were performed. Ischemic etiology of HF was confirmed in 25 subjects. The subgroups of cardiomyopathy were compared in terms of the improvement in relative and absolute values of the parameters at 6 and 12 months. At baseline, the subgroups did not differ significantly in demographic data and the measured parameters. All patients completed the first period of follow‑up showing clinical improvement after pacemaker upgrade. A significantly greater relative increase in the left ventricular ejection fraction was observed in the NIC subgroup at 6 months. The whole 12-month follow-up period was completed by a similar percentage of the IC and NIC patients (76% vs. 88.9%; P = 0.73). In the IC subgroup, a greater degree of mitral regurgitation was observed. Patients with IC or NIC who underwent an upgrade from right ventricular apical to biventricular or bifocal right ventricular pacing and completed a 12-month follow-up did not differ in clinical improvement. Significant differences were observed in echocardiographic parameters.

Serum Vitamin D Status and Its Relationship to Metabolic Parameters in Patients with Type 2 Diabetes Mellitus

The potential relationship between vitamin D (VitD) status and metabolic control in patients with type 2 diabetes mellitus (T2DM) warrants further study. We aimed to evaluate the relationship between the serum 25-hydroxyvitamin D [25(OH)D] level and various parameters in patients with T2DM. We analyzed retrospectively data from 276 Korean patients with T2DM whose serum 25(OH)D level was measured in our hospital. Nondiabetic healthy subjects who visited the hospital for health screening were selected as the control group (Non-DM, n=160). Compared with control subjects, patients with T2DM had a lower serum 25(OH)D level (15.4±0.5 vs. 12.9±0.4 ng/ml, p<0.01). Eleven percent of T2DM patients were VitD "insufficient" (20-29 ng/ml) and 87% of the patients were VitD "deficient" (<20 ng/ml). The serum 25(OH)D level was significantly related to serum fibrinogen, triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), ferritin, the urine albumin creatinine ratio, and hemoglobin A1C (HbA1C). In a multivariate logistic regression analysis, high levels of HbA1C, TG, and LDL-C were independently associated with VitD deficiency in T2DM patients. The results of the present study show that the majority of Koreans with T2DM are VitD deficient, and the serum 25(OH)D level in patients with T2DM is related to lipid and glucose parameters. Further studies are required of the relationship of VitD with fibrinogen and other related parameters.

Combined therapy with L-Thyroxine and L-Triiodothyronine compared to L-Thyroxine alone in the treatment of primary hypothyroidism

The objective of this study was to compare various parameters in patients with hypothyroidism receiving either monotherapy with L-thyroxine (L-T4) or combination therapy with L-T4 and L-triiodothyronine (L-T3). We conducted a randomized, controlled trial in 36 premenopausal women with hypothyroidism. The patients were divided into two groups: Group A (n=20) received only L-T4, while Group B received the combination L-T4 and L-T3. The treatment period lasted for 6 months. At baseline, the various parameters examined did not differ in the two groups. No significant difference between monotherapy and combined therapy was demonstrated on TSH level, ECG monitoring, densitometry, or thyroid symptoms score. The lipid profile was better during combined treatment compared to L-T4 alone; in Group A during treatment with L-T4 the levels of cholesterol and low density lipoprotein (LDL) cholesterol were unchanged, while in group B total cholesterol and LDL decreased (p<0.05). The changes in osteocalcin levels did not differ in the two groups, whereas the levels of urine deoxypyridinoline at the end of therapy were higher in the group with combination therapy, compared to monotherapy. Compared with L-T4 alone, replacement therapy with the combination of L-T4+L-T3 shows favourable changes in serum lipid profile, but higher activation of bone resorption.

Effects of a Low-Dose Fish Oil Concentrate on Angina, Exercise Tolerance Time, Serum Triglycerides, and Platelet Function

Fish oils have shown beneficial effects on various parameters in patients with coronary artery disease (CAD). The purpose of this study was to investigate whether the same effects can be demonstrated with a low dose of fish oil concentrate (FOC). Thirty-nine patients were studied and divided into two groups. Twenty were given 10 g fish oil (group A) and 19 were given 10 g placebo Italian olive oil (group B). Weekly anginal attacks (AA), weekly glyceryl trinitrate consumption (GTN), exercise tolerance time (ETT), serum triglycerides (ST), platelet aggregation ratio (PAR), and beta-thromboglobulin were measured at eight and twelve weeks after start of treatment. 1. The number of anginal attacks recorded by both groups decreased by 41% in group A reaching statistical significance (P < 0.05). No change was observed in group B. 2. GTN consumption decreased in group A (P < 0.05) with no significant change in group B (P:ns). 3. ETT increased significantly in group A eight and twelve weeks after start of treatment (20.6% P < 0.01, 22.6% P < 0.01). A smaller but insignificant increase was observed in group B (P: ns). 4. ST decreased significantly in group A by 22% eight weeks after start of treatment (P < 0.01) and to a lesser degree (11%) twelve weeks after start of treatment (P: ns). In group B, ST slightly increased (P: ns). 5. No statistically significant change was observed in either group in regard to PAR and beta-thromboglobulin (P: ns). These observations suggest that dietary supplementation with a low dose of FOC may have beneficial effects on the clinical status of patients with CAD.(ABSTRACT TRUNCATED AT 250 WORDS)