Pub Date : 2023-05-31DOI: 10.37349/emed.2023.00144
Regina Frontera, M. Barone
In the context of in-hospital care management, the need for infusion therapies involves the choice of appropriate devices. Historically, there is no consensus about the preference for vascular accesses, although the data present in the literature would seem to favor peripheral ones due to fearful complications and a non-negligible rate of bloodstream infections. It is also true the decision for central routes is sometimes dictated by the patient’s general clinical conditions (especially as a result of surgery) or by the need to establish continuous short or long-term support therapies. Therefore, it would seem anachronistic to favor one strategy rather than another. Probably data should be reviewed, considering and evaluating the correct application of indications and guidelines for both positioning and management of venous accesses, without facing methodological biases that could lead to scarcy and inconclusive results; although it is undeniable that some conditions promote the onset of complications.
{"title":"Vascular accesses: Which choice? Less is more, more or less","authors":"Regina Frontera, M. Barone","doi":"10.37349/emed.2023.00144","DOIUrl":"https://doi.org/10.37349/emed.2023.00144","url":null,"abstract":"In the context of in-hospital care management, the need for infusion therapies involves the choice of appropriate devices. Historically, there is no consensus about the preference for vascular accesses, although the data present in the literature would seem to favor peripheral ones due to fearful complications and a non-negligible rate of bloodstream infections. It is also true the decision for central routes is sometimes dictated by the patient’s general clinical conditions (especially as a result of surgery) or by the need to establish continuous short or long-term support therapies. Therefore, it would seem anachronistic to favor one strategy rather than another. Probably data should be reviewed, considering and evaluating the correct application of indications and guidelines for both positioning and management of venous accesses, without facing methodological biases that could lead to scarcy and inconclusive results; although it is undeniable that some conditions promote the onset of complications.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48633755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-30DOI: 10.37349/emed.2023.00143
R. N. Khramova, T. Eliseeva, E. Tush, D. Ovsyannikov, V. Bulgakova, Georgii S. Ignatov, Lamara A. Oganyan, O. Khaletskaya
Aim: Being overweight and obesity are factors in the negative modification of bronchial asthma (BA). The mechanisms of the aggravating effect of obesity on the course of BA have not yet been fully determined, but include changes in external respiration. The aim of the study was to study the effect of being overweight/obesity on spirometric parameters and on the occurrence of dysanapsis in children and adolescents with BA. Methods: It was a cross-sectional, open, single-center study. The data were obtained from 428 patients with atopic BA aged 7 years to 17 years, 12.0 [9.0; 14.0], and 72.9% (312/428) of them were boys. The children were divided into 3 groups: group 1—normal body weight; group 2—overweight; and group 3—obesity. All participants underwent spirometry, the ratio of forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) was calculated and the diagnosis of dysanapsis was performed. Results: As body weight increases, a progressive decrease in FEV1/FVC is revealed—group 1: 79.55% [71.37; 85.43]; group 2: 76.82% [70.12; 82.03]; and group 3: 76.28% [67.04; 79.89] P = 0.004; as well as a decrease in Z FEV1/FVC: group 1—1.23 [–2.18; –0.28]; group 2—1.54 [–2.19; –0.68]; and group 3—1.75 [–2.63; –0.90] P = 0.02. Dysanapsis was detected in 37.7% (159/428) of patients. The incidence of dysanapsis increased statistically significantly with increasing body mass index (BMI) and amounted to: with normal body weight—31.7% (77/243), with overweight—42.0% (55/131), and with obesity—50% (27/54) P = 0.016. Conclusions: In children and adolescents with BA, as BMI increases, there is a statistically significant decrease in the ratio of FEV1/FVC, and, consequently, bronchial patency; the incidence of dysanapsis also increases statistically significantly. Taken together, this indicates the formation of an obstructive pattern of external respiration under the influence of being overweight and obesity in children and adolescents with BA.
{"title":"Effect of overweight and obesity on spirometric parameters in children and adolescent with asthma","authors":"R. N. Khramova, T. Eliseeva, E. Tush, D. Ovsyannikov, V. Bulgakova, Georgii S. Ignatov, Lamara A. Oganyan, O. Khaletskaya","doi":"10.37349/emed.2023.00143","DOIUrl":"https://doi.org/10.37349/emed.2023.00143","url":null,"abstract":"Aim: Being overweight and obesity are factors in the negative modification of bronchial asthma (BA). The mechanisms of the aggravating effect of obesity on the course of BA have not yet been fully determined, but include changes in external respiration. The aim of the study was to study the effect of being overweight/obesity on spirometric parameters and on the occurrence of dysanapsis in children and adolescents with BA. Methods: It was a cross-sectional, open, single-center study. The data were obtained from 428 patients with atopic BA aged 7 years to 17 years, 12.0 [9.0; 14.0], and 72.9% (312/428) of them were boys. The children were divided into 3 groups: group 1—normal body weight; group 2—overweight; and group 3—obesity. All participants underwent spirometry, the ratio of forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) was calculated and the diagnosis of dysanapsis was performed. Results: As body weight increases, a progressive decrease in FEV1/FVC is revealed—group 1: 79.55% [71.37; 85.43]; group 2: 76.82% [70.12; 82.03]; and group 3: 76.28% [67.04; 79.89] P = 0.004; as well as a decrease in Z FEV1/FVC: group 1—1.23 [–2.18; –0.28]; group 2—1.54 [–2.19; –0.68]; and group 3—1.75 [–2.63; –0.90] P = 0.02. Dysanapsis was detected in 37.7% (159/428) of patients. The incidence of dysanapsis increased statistically significantly with increasing body mass index (BMI) and amounted to: with normal body weight—31.7% (77/243), with overweight—42.0% (55/131), and with obesity—50% (27/54) P = 0.016. Conclusions: In children and adolescents with BA, as BMI increases, there is a statistically significant decrease in the ratio of FEV1/FVC, and, consequently, bronchial patency; the incidence of dysanapsis also increases statistically significantly. Taken together, this indicates the formation of an obstructive pattern of external respiration under the influence of being overweight and obesity in children and adolescents with BA.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46970904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-30DOI: 10.37349/emed.2023.00142
Reihane Mokarian Rajabi, Fariborz Mokarian Rajabi, E. Moazam, S. Mohseni, Mohammad Tarbiat, Anahita Emami, Amir Nik, Sayyideh Forough Hosseini
Aim: There is a correlation between the number of resected lymph nodes (LNs) and survival as well as staging in patients with colorectal cancer (CRC). This cohort discussed the effect of the number of dissected LNs on the prognosis [survival, disease-free survival (DFS)] of patients with stage II and III CRC. Methods: In this historical prospective cohort study, the records of 946 patients with CRC operated in the Seyyed-Al-Shohada hospital in Isfahan from 1998 to 2014 were enrolled. Then the impact of LNs on the overall survival (OS) and DFS were analyzed. Results: The number of removed LNs was higher among males [mean difference = 1.38, t (944) = 2.232, P-value = 0.02]. The median of the DFS for the patients with 1 to 20 LN removal was 104 months [95% confidence interval (CI): 90.97–117.03], while this number for the patients with more than 20 nodes was 166 months (95% CI: 140.41–191.58). DFS between two groups of CRCs, LN removal 1–20, and greater than 20. Age and number of LN removal were significant predictors of the DFS. There was a strong and statistically significant correlation between DFS and OS among CRC patients. Conclusions: This study shows that if the number of resected LNs in patients with CRC is more than 20, it will increase in DFS and OS.
{"title":"Effect of number of dissected lymph nodes on prognosis of patients with stage II and III colorectal cancer","authors":"Reihane Mokarian Rajabi, Fariborz Mokarian Rajabi, E. Moazam, S. Mohseni, Mohammad Tarbiat, Anahita Emami, Amir Nik, Sayyideh Forough Hosseini","doi":"10.37349/emed.2023.00142","DOIUrl":"https://doi.org/10.37349/emed.2023.00142","url":null,"abstract":"Aim: There is a correlation between the number of resected lymph nodes (LNs) and survival as well as staging in patients with colorectal cancer (CRC). This cohort discussed the effect of the number of dissected LNs on the prognosis [survival, disease-free survival (DFS)] of patients with stage II and III CRC.\u0000Methods: In this historical prospective cohort study, the records of 946 patients with CRC operated in the Seyyed-Al-Shohada hospital in Isfahan from 1998 to 2014 were enrolled. Then the impact of LNs on the overall survival (OS) and DFS were analyzed.\u0000Results: The number of removed LNs was higher among males [mean difference = 1.38, t (944) = 2.232, P-value = 0.02]. The median of the DFS for the patients with 1 to 20 LN removal was 104 months [95% confidence interval (CI): 90.97–117.03], while this number for the patients with more than 20 nodes was 166 months (95% CI: 140.41–191.58). DFS between two groups of CRCs, LN removal 1–20, and greater than 20. Age and number of LN removal were significant predictors of the DFS. There was a strong and statistically significant correlation between DFS and OS among CRC patients.\u0000Conclusions: This study shows that if the number of resected LNs in patients with CRC is more than 20, it will increase in DFS and OS.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46290902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-27DOI: 10.37349/emed.2023.00140
P. Misra, Rahul Gopinath, N. Naredi, S. M. Kandi, Shyam Raj, Y. Vashum
Aim: Polycystic ovarian syndrome (PCOS) is the most common endocrine condition, affecting 5–7% of reproductive-age women worldwide. It is associated with low-grade chronic inflammation, insulin resistance, and metabolic syndrome. Studies have shown ceruloplasmin (Cp) as an independent risk factor for metabolic syndrome and magnesium (Mg), which is required for proper glucose utilization. This study aimed to compare the serum Mg and Cp in PCOS and healthy women and correlate their levels with changes in biochemical, hormonal, and gynaecological aspects of PCOS. Methods: The study comprised 98 women diagnosed with PCOS using the Rotterdam criteria and 75 age-matched healthy control subjects. The level of serum Cp and Mg were determined using Somani Ambade colorimetric method and methylthymol blue method respectively. Results: Serum Cp was higher and Mg levels were lower significantly in PCOS patients in comparison with controls. Mg was inversely correlated with fasting blood glucose and directly correlated with follicle-stimulating hormone (FSH). Cp was inversely correlated with prolactin and thyroid-stimulating hormone. Multiple regression analysis revealed that Cp correlates with both the level of luteinizing hormone (LH) and LH/FSH ratio, whereas serum Mg did not have a significant correlation with any of the clinical variables. Logistic regression analysis revealed elevated Cp, antral follicle count (AFC), body mass index (BMI), weight, and irregular menses increase the risk of developing PCOS, whereas Mg was not a risk factor. However, high LH and LH/FSH ratios were risk factors for hypomagnesemia. In conclusion, serum Cp levels in PCOS may be evaluated as an additional risk factor in association with AFC, BMI, weight, and irregular menses. Conclusions: Mg deficiency and high Cp play an important etiological role in PCOS pathogenesis. Thus, research evaluating dietary interventions and supplementation is warranted.
{"title":"Serum levels of ceruloplasmin and magnesium in polycystic ovarian syndrome: a cross sectional study","authors":"P. Misra, Rahul Gopinath, N. Naredi, S. M. Kandi, Shyam Raj, Y. Vashum","doi":"10.37349/emed.2023.00140","DOIUrl":"https://doi.org/10.37349/emed.2023.00140","url":null,"abstract":"Aim: Polycystic ovarian syndrome (PCOS) is the most common endocrine condition, affecting 5–7% of reproductive-age women worldwide. It is associated with low-grade chronic inflammation, insulin resistance, and metabolic syndrome. Studies have shown ceruloplasmin (Cp) as an independent risk factor for metabolic syndrome and magnesium (Mg), which is required for proper glucose utilization. This study aimed to compare the serum Mg and Cp in PCOS and healthy women and correlate their levels with changes in biochemical, hormonal, and gynaecological aspects of PCOS.\u0000Methods: The study comprised 98 women diagnosed with PCOS using the Rotterdam criteria and 75 age-matched healthy control subjects. The level of serum Cp and Mg were determined using Somani Ambade colorimetric method and methylthymol blue method respectively.\u0000Results: Serum Cp was higher and Mg levels were lower significantly in PCOS patients in comparison with controls. Mg was inversely correlated with fasting blood glucose and directly correlated with follicle-stimulating hormone (FSH). Cp was inversely correlated with prolactin and thyroid-stimulating hormone. Multiple regression analysis revealed that Cp correlates with both the level of luteinizing hormone (LH) and LH/FSH ratio, whereas serum Mg did not have a significant correlation with any of the clinical variables. Logistic regression analysis revealed elevated Cp, antral follicle count (AFC), body mass index (BMI), weight, and irregular menses increase the risk of developing PCOS, whereas Mg was not a risk factor. However, high LH and LH/FSH ratios were risk factors for hypomagnesemia. In conclusion, serum Cp levels in PCOS may be evaluated as an additional risk factor in association with AFC, BMI, weight, and irregular menses.\u0000Conclusions: Mg deficiency and high Cp play an important etiological role in PCOS pathogenesis. Thus, research evaluating dietary interventions and supplementation is warranted.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46671097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-27DOI: 10.37349/emed.2023.00139
E. Kupek
Aim: To investigate the causal impact of diet and sedentary behavior on Brazilian schoolchildren’s overweight/obesity using the data from observational studies. Methods: Annual cross-sectional nutritional surveys over the 2013–2015 period, with 26,712 children old 7–12 years in Florianópolis, Brazil, provided the data for this analysis. The surveys applied an online previous-day recall questionnaire on food intake and physical/sedentary activities. Outcome measures were overweight/obesity, whereas exposure variables were daily frequencies of consuming sugary drinks and ultra-processed foods, the total number of dietary items consumed and the total number of sedentary activities per day, and consuming breakfast, mid-morning snacks, lunch, afternoon snack, dinner, and evening snack. Control variables included child age, sex, family income, school shift, survey year, day of the week the questionnaire refers to, metabolic equivalents (METs) of physical activities (PAs), and the quality of dietary and PA reports. Causal effects were estimated by augmented inverse probability weighting. Results: Daily consumption of sugary drinks, eating ten or more foods, and engaging in three or more sedentary behaviors per day significantly increased the odds ratios (ORs) of being overweight/obese in the range of 3–24% compared to the reference, with 95% confidence intervals in the range of 1–32%. Among 19 ORs with P-value ≤ 0.05, only 3 exceeded 10%. Conclusions: Under certain conditions, not uncommon in large-scale monitoring and surveillance studies, it is possible to evaluate the causal effects of diet and sedentary activities on overweight/obesity. Daily consumption of sugar-sweetened beverages, eating ten or more foods, skipping breakfast, and engaging in three or more sedentary behaviors per day significantly increased the odds of being overweight/obese.
{"title":"Can we estimate the causal effects of diet and sedentary behavior on schoolchildren’s overweight/obesity from observational studies?","authors":"E. Kupek","doi":"10.37349/emed.2023.00139","DOIUrl":"https://doi.org/10.37349/emed.2023.00139","url":null,"abstract":"Aim: To investigate the causal impact of diet and sedentary behavior on Brazilian schoolchildren’s overweight/obesity using the data from observational studies.\u0000Methods: Annual cross-sectional nutritional surveys over the 2013–2015 period, with 26,712 children old 7–12 years in Florianópolis, Brazil, provided the data for this analysis. The surveys applied an online previous-day recall questionnaire on food intake and physical/sedentary activities. Outcome measures were overweight/obesity, whereas exposure variables were daily frequencies of consuming sugary drinks and ultra-processed foods, the total number of dietary items consumed and the total number of sedentary activities per day, and consuming breakfast, mid-morning snacks, lunch, afternoon snack, dinner, and evening snack. Control variables included child age, sex, family income, school shift, survey year, day of the week the questionnaire refers to, metabolic equivalents (METs) of physical activities (PAs), and the quality of dietary and PA reports. Causal effects were estimated by augmented inverse probability weighting.\u0000Results: Daily consumption of sugary drinks, eating ten or more foods, and engaging in three or more sedentary behaviors per day significantly increased the odds ratios (ORs) of being overweight/obese in the range of 3–24% compared to the reference, with 95% confidence intervals in the range of 1–32%. Among 19 ORs with P-value ≤ 0.05, only 3 exceeded 10%.\u0000Conclusions: Under certain conditions, not uncommon in large-scale monitoring and surveillance studies, it is possible to evaluate the causal effects of diet and sedentary activities on overweight/obesity. Daily consumption of sugar-sweetened beverages, eating ten or more foods, skipping breakfast, and engaging in three or more sedentary behaviors per day significantly increased the odds of being overweight/obese.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47838412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-26DOI: 10.37349/emed.2023.00138
G. Giordano, R. Martin-Willett, Laurel P. Gibson, D. Camidge, D. Bowles, K. Hutchison, A. Bryan
Aim: Given the myriad of negative sequalae associated with cancer and its treatment, the palliative use of cannabis by cancer patients is increasingly of special interest. This research sought to explore associations of acute and sustained use of legal market edible cannabis products on pain, cognition, and quality of life in a group of cancer patients. Methods: In this observational study, cancer patients completed a baseline appointment, a two-week ad libitum cannabis use period, and an acute administration appointment that included assessments before cannabis use, one-hour post-use, and two-hour post-use. Participants completed self-report questionnaires related to the primary outcomes and the Stroop task as a measure of objective cognitive function. Results: Twenty-five participants [mean (standard deviation, SD) age = 54.3 years (15.6); 13 females (52.0%)] completed all study appointments and were included in the analysis. Sustained cannabis use was associated with improvements in pain intensity, pain interference, sleep quality, subjective cognitive function, and reaction times in the Stroop task, but no change in general quality of life was observed. High levels of cannabidiol (CBD) use during the two-week ad libitum use period was associated with steeper improvements in pain intensity and sleep quality. Participants reported improvements in pain intensity and increased feelings of subjective high after acute use. High levels of ∆9-tetrahydrocannabinol (THC) use during the acute administration appointment was associated with steeper increases in feelings of subjective high. Improvements in pain were associated with improvements in subjective cognitive function. Conclusions: This observational study is among the first of its kind to examine associations between legal market, palliative cannabis use, and subjective and objective outcomes among cancer patients. These early findings concerning pain intensity, sleep quality, and cognitive function can help to inform future, fully powered studies of this important topic (ClinicalTrials.gov identifier: NCT03617692).
{"title":"Cannabis use in cancer patients: acute and sustained associations with pain, cognition, and quality of life","authors":"G. Giordano, R. Martin-Willett, Laurel P. Gibson, D. Camidge, D. Bowles, K. Hutchison, A. Bryan","doi":"10.37349/emed.2023.00138","DOIUrl":"https://doi.org/10.37349/emed.2023.00138","url":null,"abstract":"Aim: Given the myriad of negative sequalae associated with cancer and its treatment, the palliative use of cannabis by cancer patients is increasingly of special interest. This research sought to explore associations of acute and sustained use of legal market edible cannabis products on pain, cognition, and quality of life in a group of cancer patients.\u0000Methods: In this observational study, cancer patients completed a baseline appointment, a two-week ad libitum cannabis use period, and an acute administration appointment that included assessments before cannabis use, one-hour post-use, and two-hour post-use. Participants completed self-report questionnaires related to the primary outcomes and the Stroop task as a measure of objective cognitive function.\u0000Results: Twenty-five participants [mean (standard deviation, SD) age = 54.3 years (15.6); 13 females (52.0%)] completed all study appointments and were included in the analysis. Sustained cannabis use was associated with improvements in pain intensity, pain interference, sleep quality, subjective cognitive function, and reaction times in the Stroop task, but no change in general quality of life was observed. High levels of cannabidiol (CBD) use during the two-week ad libitum use period was associated with steeper improvements in pain intensity and sleep quality. Participants reported improvements in pain intensity and increased feelings of subjective high after acute use. High levels of ∆9-tetrahydrocannabinol (THC) use during the acute administration appointment was associated with steeper increases in feelings of subjective high. Improvements in pain were associated with improvements in subjective cognitive function.\u0000Conclusions: This observational study is among the first of its kind to examine associations between legal market, palliative cannabis use, and subjective and objective outcomes among cancer patients. These early findings concerning pain intensity, sleep quality, and cognitive function can help to inform future, fully powered studies of this important topic (ClinicalTrials.gov identifier: NCT03617692).","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43655058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-26DOI: 10.37349/emed.2023.00136
V. Law, Jack Hong Ming Young, Hak Yung Ng, Louis Tsz Wang Chan
Aim: Childhood obesity is accompanied by an increased prevalence of abnormal glucose tolerance (AGT) including the prediabetes states. This study aims to investigate and evaluate the use of oral glucose tolerance test (OGTT) for detecting AGT among overweight and obese children. Methods: A retrospective study was conducted on 895 overweight and obese Chinese children (6–18 years) with obesity assessment and analysis of demographic, anthropometric, and biochemical parameters data between January 2006 and December 2015 at Tseung Kwan O Hospital, Hong Kong Special Administrative Region. Results: The proportion of males and older age group was 63.7% and 55.9%, respectively. Girls were more in older age groups (62.7% vs. 52.0%, P = 0.002). AGT occurred in 17.1% of the cohort [impaired glucose tolerance (IGT) was the most frequent morbidity (11.3%)]. After regression analysis, female sex, low-density lipoprotein (LDL), triglyceride (TG), older age group, and homeostasis model assessment of insulin resistance (HOMA-IR) ≥ 4.1 were significantly associated with AGT. Conclusions: AGT is common in overweight and obese Chinese children. Girls, older age, higher LDL, TG and HOMA-IR ≥ 4.1 showed significant association with AGT. OGTT is essential and fit-for-purpose to detect AGT in overweight and obese children.
目的:儿童肥胖伴随着异常糖耐量(AGT)的患病率增加，包括前驱糖尿病状态。本研究旨在探讨和评价口服糖耐量试验(OGTT)在超重和肥胖儿童中检测AGT的应用。方法:对2006年1月至2015年12月在香港将军澳医院就诊的895名超重和肥胖中国儿童(6-18岁)进行肥胖评估，并分析人口统计学、人体测量学和生化参数数据。结果:男性占63.7%，老年占55.9%。较大年龄组中女孩较多(62.7% vs. 52.0%， P = 0.002)。AGT发生率为17.1%[糖耐量受损(IGT)是最常见的发病率(11.3%)]。经回归分析，女性、低密度脂蛋白(LDL)、甘油三酯(TG)、年龄较大、胰岛素抵抗稳态模型评估(HOMA-IR)≥4.1与AGT显著相关。结论:AGT在中国超重和肥胖儿童中普遍存在。女孩、年龄较大、LDL、TG较高、HOMA-IR≥4.1与AGT有显著相关性。OGTT对于检测超重和肥胖儿童的AGT至关重要。
{"title":"Abnormal glucose tolerance in children: oral glucose tolerance test is fit-for-purpose","authors":"V. Law, Jack Hong Ming Young, Hak Yung Ng, Louis Tsz Wang Chan","doi":"10.37349/emed.2023.00136","DOIUrl":"https://doi.org/10.37349/emed.2023.00136","url":null,"abstract":"Aim: Childhood obesity is accompanied by an increased prevalence of abnormal glucose tolerance (AGT) including the prediabetes states. This study aims to investigate and evaluate the use of oral glucose tolerance test (OGTT) for detecting AGT among overweight and obese children.\u0000Methods: A retrospective study was conducted on 895 overweight and obese Chinese children (6–18 years) with obesity assessment and analysis of demographic, anthropometric, and biochemical parameters data between January 2006 and December 2015 at Tseung Kwan O Hospital, Hong Kong Special Administrative Region.\u0000Results: The proportion of males and older age group was 63.7% and 55.9%, respectively. Girls were more in older age groups (62.7% vs. 52.0%, P = 0.002). AGT occurred in 17.1% of the cohort [impaired glucose tolerance (IGT) was the most frequent morbidity (11.3%)]. After regression analysis, female sex, low-density lipoprotein (LDL), triglyceride (TG), older age group, and homeostasis model assessment of insulin resistance (HOMA-IR) ≥ 4.1 were significantly associated with AGT.\u0000Conclusions: AGT is common in overweight and obese Chinese children. Girls, older age, higher LDL, TG and HOMA-IR ≥ 4.1 showed significant association with AGT. OGTT is essential and fit-for-purpose to detect AGT in overweight and obese children.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41352393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-26DOI: 10.37349/emed.2023.00134
G. Annarumma, Alessandro Spinelli, Alessandro Serio, Tammaro Di Fraia, Carlo Maria Gallinoro, Lucrezia Caoduro, D. Tarantino, A. Demeco, Erica Keeling, S. Palermi, A. Biffi, F. Sirico
Aim: Forward head posture (FHP) is a very common pathological neck posture among people who frequently use multimedia devices, and it could be related to some musculoskeletal disorders. However, its role in influencing lung function and its relationship with neck disability are still debated in the literature. Therefore, the aim of the present study was to investigate the influence of FHP on respiratory function, and to explore a possible relationship between FHP and neck discomfort. Methods: A cross-sectional study was conducted on a sample of 83 subjects (35.7 ± 8.4 years aged), enrolled at the Ferrari corporate wellness program “Formula Benessere”. Craniovertebral angle (CVA) was measured with a digital goniometer to assess head posture: FHP was defined with a CVA < 50° in an upright position. Spirometry was conducted according to European Respiratory Society/American Thoracic Society (ERS/ATS) criteria. Finally, subjects enrolled were evaluated through a self-administered neck disability index (NDI) questionnaire. Results: Among the 60 participants with agreement about the CVA measurements, 45 had FHP (11 females and 34 males) with lower CVA values. No significant differences were found in spirometric parameters between subjects with FHP (n = 45) and subjects without FHP (n = 15). Furthermore, the two groups did not differ either in NDI scores (P = 0.148). Conclusions: There is no clear relationship between FHP and respiratory function indices. Moreover, no differences have been found in NDI values between subjects with FHP and subjects without FHP. Respiratory rehabilitation strategies should be focused on other parameters than FHP itself.
{"title":"Forward head posture and neck disability: what is the effect on lung function?","authors":"G. Annarumma, Alessandro Spinelli, Alessandro Serio, Tammaro Di Fraia, Carlo Maria Gallinoro, Lucrezia Caoduro, D. Tarantino, A. Demeco, Erica Keeling, S. Palermi, A. Biffi, F. Sirico","doi":"10.37349/emed.2023.00134","DOIUrl":"https://doi.org/10.37349/emed.2023.00134","url":null,"abstract":"Aim: Forward head posture (FHP) is a very common pathological neck posture among people who frequently use multimedia devices, and it could be related to some musculoskeletal disorders. However, its role in influencing lung function and its relationship with neck disability are still debated in the literature. Therefore, the aim of the present study was to investigate the influence of FHP on respiratory function, and to explore a possible relationship between FHP and neck discomfort.\u0000Methods: A cross-sectional study was conducted on a sample of 83 subjects (35.7 ± 8.4 years aged), enrolled at the Ferrari corporate wellness program “Formula Benessere”. Craniovertebral angle (CVA) was measured with a digital goniometer to assess head posture: FHP was defined with a CVA < 50° in an upright position. Spirometry was conducted according to European Respiratory Society/American Thoracic Society (ERS/ATS) criteria. Finally, subjects enrolled were evaluated through a self-administered neck disability index (NDI) questionnaire.\u0000Results: Among the 60 participants with agreement about the CVA measurements, 45 had FHP (11 females and 34 males) with lower CVA values. No significant differences were found in spirometric parameters between subjects with FHP (n = 45) and subjects without FHP (n = 15). Furthermore, the two groups did not differ either in NDI scores (P = 0.148).\u0000Conclusions: There is no clear relationship between FHP and respiratory function indices. Moreover, no differences have been found in NDI values between subjects with FHP and subjects without FHP. Respiratory rehabilitation strategies should be focused on other parameters than FHP itself.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42963127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-26DOI: 10.37349/emed.2023.00137
Mauro G. Silva, F. Inserra, J. Mariani, Laura Antonietti, M. Núñez, C. Tajer, L. Ferder, P. Inserra, F. Ross, Milagro Sánchez Cunto, Magalí Bertelli, G. de Larrañaga, Eliana M Cela, D. Maglio, M. Gironacci, W. Manucha
Aim: To evaluate angiotensin II (Ang II) and Ang-(1-7) levels and the cytokine profile in patients hospitalized with mild coronavirus disease 2019 (COVID-19) and contrast them with patients with identical clinical conditions but treated with high doses of vitamin D (vitD). Methods: From the 218 patients recruited (ClinicalTrials.gov NCT04411446), 16 participated in this sub-study and were randomized to a single oral dose of 500,000 IU vitD (n = 10) or placebo (n = 6). Plasmatic Ang II and Ang-(1-7) levels were determined by radioimmunoassay and interleukins (ILs) 1, 6, 8, and 10 and tumor necrosis factor alpha (TNF-α) by enzyme-linked immunosorbent assay before and after treatment. Parallel, serum 25-hydroxyvitamin D3 (25-OH vitD) concentrations as vitD status was measured by a chemiluminescence immunoassay. Results: A trend towards an increase in Ang-(1-7) and a decrease in Ang II levels were observed in placebo- and vitD-treated COVID-19 patients compared to baseline values. There was no difference in Ang II and Ang-(1-7) levels between placebo- and vitD-treated COVID-19 patients. Similar results were obtained with ILs profile. COVID-19 patients showed an increase in the protective component of the RAS which was not improved by vitD treatment. Conclusions: VitD did not improve RAS disbalance in COVID-19. Notwithstanding, the authors visualize that acute treatment with high doses of vitD may show a trend to a decline in inflammatory ILs and an increase in protective markers. Finally, the authors would like to highlight the limitations of this preliminary study, namely the small number of patients and the use of a large single bolus dose of vitD rather than lower daily doses for extended periods with prolonged follow-up times. All these factors need special consideration in the designs of new vitD supplementation trials. All these factors need special consideration in the designs of new vitD supplementation trials (ClinicalTrials.gov identifier: NCT04411446).
{"title":"Mechanistic approaching study in COVID-19 patients treated with high doses of vitamin D","authors":"Mauro G. Silva, F. Inserra, J. Mariani, Laura Antonietti, M. Núñez, C. Tajer, L. Ferder, P. Inserra, F. Ross, Milagro Sánchez Cunto, Magalí Bertelli, G. de Larrañaga, Eliana M Cela, D. Maglio, M. Gironacci, W. Manucha","doi":"10.37349/emed.2023.00137","DOIUrl":"https://doi.org/10.37349/emed.2023.00137","url":null,"abstract":"Aim: To evaluate angiotensin II (Ang II) and Ang-(1-7) levels and the cytokine profile in patients hospitalized with mild coronavirus disease 2019 (COVID-19) and contrast them with patients with identical clinical conditions but treated with high doses of vitamin D (vitD).\u0000Methods: From the 218 patients recruited (ClinicalTrials.gov NCT04411446), 16 participated in this sub-study and were randomized to a single oral dose of 500,000 IU vitD (n = 10) or placebo (n = 6). Plasmatic Ang II and Ang-(1-7) levels were determined by radioimmunoassay and interleukins (ILs) 1, 6, 8, and 10 and tumor necrosis factor alpha (TNF-α) by enzyme-linked immunosorbent assay before and after treatment. Parallel, serum 25-hydroxyvitamin D3 (25-OH vitD) concentrations as vitD status was measured by a chemiluminescence immunoassay.\u0000Results: A trend towards an increase in Ang-(1-7) and a decrease in Ang II levels were observed in placebo- and vitD-treated COVID-19 patients compared to baseline values. There was no difference in Ang II and Ang-(1-7) levels between placebo- and vitD-treated COVID-19 patients. Similar results were obtained with ILs profile. COVID-19 patients showed an increase in the protective component of the RAS which was not improved by vitD treatment.\u0000Conclusions: VitD did not improve RAS disbalance in COVID-19. Notwithstanding, the authors visualize that acute treatment with high doses of vitD may show a trend to a decline in inflammatory ILs and an increase in protective markers. Finally, the authors would like to highlight the limitations of this preliminary study, namely the small number of patients and the use of a large single bolus dose of vitD rather than lower daily doses for extended periods with prolonged follow-up times. All these factors need special consideration in the designs of new vitD supplementation trials. All these factors need special consideration in the designs of new vitD supplementation trials (ClinicalTrials.gov identifier: NCT04411446).","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46927450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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