Search results for: dried blood spots
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3127

Search results for: dried blood spots

2497 Examining the Effects of Exercise and Healthy Diet on Certain Blood Parameter Levels, Oxidative Stress and Anthropometric Measurements in Slightly Overweight Women

Authors: Nezihe Şengün, Ragip Pala

Abstract:

To prevent overweight and obesity, individuals need to consume food and beverages according to their nutritional needs, engage in regular exercises, and regularly monitor their body weight. This study aimed to examine the effects of exercise, diet, or combined intervention on changes in blood lipid parameters (total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides) and the level of malondialdehyde (MDA), a marker of oxidative stress, in parallel with the increase in body weight due to poor nutrition and sedentary lifestyle conditions. The study included a total of 48 female students aged 18-28 years with a BMI between 25.0 and 29.9 kg/m². They were divided into four groups: control (C), exercise (Ex), diet (D), and exercise+diet (Ex+D). Those in the exercise groups received aerobic exercises at 60-70% intensity (10 minutes warm-up, 30 minutes running, 10 minutes cool-down), while those in the diet groups were provided with a diet program based on the calculation of energy needs considering basal metabolic rate, physical activity level, age, and BMI. The students’ body weight, body fat mass, Body Mass Index (BMI), and waist-hip ratios were measured at the beginning (day 1) and end (day 60) of the 8-week intervention period. Their total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, and MDA levels were evaluated and analyzed, considering a statistical significance level of p<0.05. As a result, female students in the Ex+D group had the largest difference in body weight, body fat mass, BMI, and waist-hip ratios, and this difference was statistically significant. Except for those in the C group, those in the other groups experienced a decrease in their total cholesterol, LDL cholesterol, and triglyceride levels and an increase in their HDL cholesterol levels. The decrease in total cholesterol, LDL cholesterol, and triglyceride levels was statistically significant for those in the D group, and the increase in HDL cholesterol level was statistically significant for those in the Ex+D group (p<0.05). A decrease in MDA level was found in all groups except those in the C group, and this decrease was significantly higher in the Ex group. In conclusion, our study revealed that the most effective way to achieve weight loss is through a combination of exercise and diet. The application of Ex+D is considered to balance blood lipid levels and suppress oxidative stress.

Keywords: obesity, exercise, diet, body mass index, blood lipids

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2496 Radiation Induced DNA Damage and Its Modification by Herbal Preparation of Hippophae rhamnoides L. (SBL-1): An in vitro and in vivo Study in Mice

Authors: Anuranjani Kumar, Madhu Bala

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Ionising radiation exposure induces generation of free radicals and the oxidative DNA damage. SBL-1, a radioprotective leaf extract prepared from leaves Hippophae rhamnoides L. (Common name; Seabuckthorn), showed > 90% survival in mice population that was treated with lethal dose (10 Gy) of ⁶⁰Co gamma irradiation. In this study, early effects of pre-treatment with or without SBL-1 in blood peripheral blood lymphocytes (PBMCs) were investigated by cell viability assays (trypan blue and MTT). The quantitative in vitro study of Hoescht/PI staining was performed to check the apoptosis/necrosis in PBMCs irradiated at 2 Gy with or without pretreatment of SBL-1 (at different concentrations) up to 24 and 48h. Comet assay was performed in vivo, to detect the DNA strands breaks and its repair mechanism on peripheral blood lymphocytes at lethal dose (10 Gy). For this study, male mice (wt. 28 ± 2g) were administered radioprotective dose (30mg/kg body weight) of SBL-1, 30 min prior to irradiation. Animals were sacrificed at 24h and 48h. Blood was drawn through cardiac puncture, and blood lymphocytes were separated using histopaque column. Both neutral and alkaline comet assay were performed using standardized technique. In irradiated animals, alkaline comet assay revealed single strand breaks (SSBs) that showed significant (p < 0.05) increase in percent DNA in tail and Olive tail moment (OTM) at 24 h while at 48h the percent DNA in tail further increased significantly (p < 0.02). The double strands breaks (DSBs) increased significantly (p < 0.01) at 48 h in neutral assay, in comparison to untreated control. The animals pre-treated with SBL-1 before irradiation showed significantly (p < 0.05) less DSBs at 48 h treatment in comparison to irradiated group of animals. The SBL-1 alone treated group itself showed no toxicity. The antioxidant potential of SBL-1 were also investigated by in vitro biochemical assays such as DPPH (p < 0.05), ABTS, reducing ability (p < 0.09), hydroxyl radical scavenging (p < 0.05), ferric reducing antioxidant power (FRAP), superoxide radical scavenging activity (p < 0.05), hydrogen peroxide scavenging activity (p < 0.05) etc. SBL-1 showed strong free radical scavenging power that plays important role in the studies of radiation-induced injuries. The SBL-1 treated PBMCs showed significant (p < 0.02) viability in trypan blue assay at 24-hour incubation.

Keywords: radiation, SBL-1, SSBs, DSBs, FRAP, PBMCs

Procedia PDF Downloads 135
2495 Clinical Profile and Outcome of Type I Diabetes Mellitus at a Tertiary Care-Centre in Eastern Nepal

Authors: Gauri Shankar Shah

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Objectives: The Type I diabetes mellitus in children is frequently a missed diagnosis and children presents in emergency with diabetic ketoacidosis having significant morbidity and mortality. The present study was done to find out the clinical presentation and outcome at a tertiary-care centre. Methods: This was retrospective analysis of data of Type I diabetes mellitus reporting to our centre during last one year (2012-2013). Results: There were 12 patients (8 males) and the age group was 4-14 years (mean ± 3.7). The presenting symptoms were fever, vomiting, altered sensorium and fast breathing in 8 (66.6%), 6 (50%), 4 (33.3%), and 4 (33.3%) cases, respectively. The classical triad of polyuria, polydypsia, and polyphagia were present only in two patients (33.2%). Seizures and epigastric pain were found in two cases each (33.2%). The four cases (33.3%) presented with diabetic ketoacidosis due to discontinuation of insulin doses, while 2 had hyperglycemia alone. The hemogram revealed mean hemoglobin of 12.1± 1.6 g/dL and total leukocyte count was 22,883.3 ± 10,345.9 per mm3, with polymorphs percentage of 73.1 ± 9.0%. The mean blood sugar at presentation was 740 ± 277 mg/ dl (544–1240). HbA1c ranged between 7.1-8.8 with mean of 8.1±0.6 %. The mean sodium, potassium, blood ph, pCO2, pO2 and bicarbonate were 140.8 ± 6.9 mEq/L, 4.4 ± 1.8mEq/L, 7.0 ± 0.2, 20.2 ± 10.8 mmHg, 112.6 ± 46.5 mmHg and 9.2 ± 8.8 mEq/L, respectively. All the patients were managed in pediatric intensive care unit as per our protocol, recovered and discharged on intermediate insulin given twice daily. Conclusions: Thus, it shows that these patients have uncontrolled hyperglycemia and often presents in emergency with ketoacidosis and deranged biochemical profile. The regular administration of insulin, frequent monitoring of blood sugar and health education are required to have better metabolic control and good quality of life.

Keywords: type I diabetes mellitus, hyperglycemia, outcome, glycemic control

Procedia PDF Downloads 242
2494 Exploring Symptoms, Causes and Treatments of Feline Pruritus Using Thematic Analysis of Pet Owner Social Media Posts

Authors: Sitira Williams, Georgina Cherry, Andrea Wright, Kevin Wells, Taran Rai, Richard Brown, Travis Street, Alasdair Cook

Abstract:

Social media sources (50) were identified, keywords defined by veterinarians and organised into 6 topics known to be indicative of feline pruritus: body areas, behaviors, symptoms, diagnosis, and treatments. These were augmented using academic literature, a cat owner survey, synonyms, and Google Trends. The content was collected using a social intelligence solution, with keywords tagged and filtered. Data were aggregated and de-duplicated. SL content matching body areas, behaviors and symptoms were reviewed manually, and posts were marked relevant if: posted by a pet owner, identifying an itchy cat and not duplicated. A sub-set of 493 posts published from 2009-2022 was used for reflexive thematic analysis in NVIVO (Burlington, MA) to identify themes. Five themes were identified: allergy, pruritus, additional behaviors, unusual or undesirable behaviors, diagnosis, and treatment. Most (258) posts reported the cat was excessively licking, itching, and scratching. The majority were indoor cats and were less playful and friendly when itchy. Half of these posts did not indicate a known cause of pruritus. Bald spots and scabs (123) were reported, often causing swelling and fur loss, and 56 reported bumps, lumps, and dry patches. Other impacts on the cat’s quality of life were ear mites, cat self-trauma and stress. Seven posts reported their cats’ symptoms caused them ongoing anxiety and depression. Cats with food allergies to poultry (often chicken and beef) causing bald spots featured in 23 posts. Veterinarians advised switching to a raw food diet and/or changing their bowls. Some cats got worse after switching, leaving owners’ needs unmet. Allergic reactions to flea bites causing excessive itching, red spots, scabs, and fur loss were reported in 13 posts. Some (3) posts indicated allergic reactions to medication. Cats with seasonal and skin allergies, causing sneezing, scratching, headshaking, watery eyes, and nasal discharge, were reported 17 times. Eighty-five posts identified additional behaviors. Of these, 13 reported their cat’s burst pimple or insect bite. Common behaviors were headshaking, rubbing, pawing at their ears, and aggressively chewing. In some cases, bites or pimples triggered previously unseen itchiness, making the cat irritable. Twenty-four reported their cat had anxiety: overgrooming, itching, losing fur, hiding, freaking out, breathing quickly, sleeplessness, hissing and vocalising. Most reported these cats as having itchy skin, fleas, and bumps. Cats were commonly diagnosed with an ear infection, ringworm, acne, or kidney disease. Acne was diagnosed in cats with an allergy flare-up or overgrooming. Ear infections were diagnosed in itchy cats with mites or other parasites. Of the treatments mentioned, steroids were most frequently used, then anti-parasitics, including flea treatments and oral medication (steroids, antibiotics). Forty-six posts reported distress following poor outcomes after medication or additional vet consultations. SL provides veterinarians with unique insights. Verbatim comments highlight the detrimental effects of pruritus on pets and owner quality of life. This study demonstrates the need for veterinarians to communicate management and treatment options more effectively to relieve owner frustrations. Data analysis could be scaled up using machine learning for topic modeling.

Keywords: content analysis, feline, itch, pruritus, social media, thematic analysis, veterinary dermatology

Procedia PDF Downloads 166
2493 [Keynote Talk]: Mathematical and Numerical Modelling of the Cardiovascular System: Macroscale, Mesoscale and Microscale Applications

Authors: Aymen Laadhari

Abstract:

The cardiovascular system is centered on the heart and is characterized by a very complex structure with different physical scales in space (e.g. micrometers for erythrocytes and centimeters for organs) and time (e.g. milliseconds for human brain activity and several years for development of some pathologies). The development and numerical implementation of mathematical models of the cardiovascular system is a tremendously challenging topic at the theoretical and computational levels, inducing consequently a growing interest over the past decade. The accurate computational investigations in both healthy and pathological cases of processes related to the functioning of the human cardiovascular system can be of great potential in tackling several problems of clinical relevance and in improving the diagnosis of specific diseases. In this talk, we focus on the specific task of simulating three particular phenomena related to the cardiovascular system on the macroscopic, mesoscopic and microscopic scales, respectively. Namely, we develop numerical methodologies tailored for the simulation of (i) the haemodynamics (i.e., fluid mechanics of blood) in the aorta and sinus of Valsalva interacting with highly deformable thin leaflets, (ii) the hyperelastic anisotropic behaviour of cardiomyocytes and the influence of calcium concentrations on the contraction of single cells, and (iii) the dynamics of red blood cells in microvasculature. For each problem, we present an appropriate fully Eulerian finite element methodology. We report several numerical examples to address in detail the relevance of the mathematical models in terms of physiological meaning and to illustrate the accuracy and efficiency of the numerical methods.

Keywords: finite element method, cardiovascular system, Eulerian framework, haemodynamics, heart valve, cardiomyocyte, red blood cell

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2492 The Determination of Sodium/Potassium Ion Ratio in Selected Edible Leafy Vegetables in North-Eastern Nigeria

Authors: Raymond D. Uzoh, Philip K. Shallsuku, Christopher S. Vaachia

Abstract:

Selected edible leafy vegetables from North-eastern Nigeria were analysed for their sodium and potassium content in mg/100 g and the ratio Na+/K+ worked out. From experimental results, Venonia amydalina (bitter leaf) contained 150 mg (0.15 g) of sodium and 20500 mg (20.5 g) potassium with a ratio of 0.007, Brassica oleracea var capitata (cabbage) contained 300 mg (0.3 g) of sodium and 19000 mg (19 g) of potassium with a ration of 0.012. Others are Telfairia occidentalis (fluted pumpkin) with 400 mg (0.45 g) of sodium and 19500 mg (19.5 g) of potassium with a ratio of 0.020; Hibiscus sabdriffa (sorrel) has 200 mg (0.2 g) of sodium and 600 mg (0.6 g) of potassium with a ratio of 0.300; and Amarantus caudatus (spinach) contained 450 mg (0.45 g) of sodium and 23000 mg (23 g) of potassium with a ratio of 0.020. The presence of sodium and potassium in foods has become increasingly important as recent studies and dietary information gathered in this research has shown that sodium intake is not the sole consideration in elevated blood pressure but its considered as a ratio Na+/K+ fixed at 0.6. This ratio has been found to be a more important factor, suggesting that our diet should contain 67 % more potassium than sodium.

Keywords: vegetables, sodium, potassium, blood pressure, diet, foods

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2491 Reduction of Fermentation Duration of Cassava to Remove Hydrogen Cyanide

Authors: Jean Paul Hategekimana, Josiane Irakoze, Eugene Niyonzima, Annick Ndekezi

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Cassava (Manihot esculenta Crantz) is a root crop comprising an anti-nutritive factor known as cyanide. The compound can be removed by numerous processing methods such as boiling, fermentation, blanching, and sun drying to avoid the possibility of cyanide poisoning. Inappropriate processing mean can lead to disease and death. Cassava-based dishes are consumed in different ways, where cassava is cultivated according to their culture and preference. However, they have been shown to be unsafe based on high cyanide levels. The current study targeted to resolve the problem of high cyanide in cassava consumed in Rwanda. This study was conducted to determine the effect of slicing, blanching, and soaking time to reduce the fermentation duration of cassava for hydrogen cyanide (HCN) in mg/g removal. Cassava was sliced into three different portions (1cm, 2cm, and 5cm). The first portions were naturally fermented for seven days, where each portion was removed every 24 hours from soaking tanks and then oven dried at a temperature of 60°C and then milled to obtain naturally fermented cassava flours. Other portions of 1cm, 2cm, and 5cm were blanched for 2, 5, 10 min, respectively, and each similarly dried at 60°C and milled to produce blanched cassava flour. Other blanched portions were used to follow the previous fermentation steps. The last portions, which formed the control, were simply chopped. Cyanide content and starch content in mg/100g were investigated. According to the conducted analysis on different cassava treatments for detoxification, found that usual fermentation can be used, but for sliced portions aimed to size reduction for the easy hydrogen cyanide diffuse out and it takes four days to complete fermentation, which has reduced at 94.44% with significantly different (p<0.05)of total hydrogen cyanide contained in cassava to safe level of consumption, and what is recommended as more effective is to apply blanching combined with fermentation due to the fact that, it takes three days to complete hydrogen cyanide removal at 95.56% on significantly different (p<0.05) of reduction to the safe level of consumption.

Keywords: cassava, cyanide, blanching, drying, fermentation

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2490 Potential Therapeutic Effect of Obestatin in Oral Mucositis

Authors: Agnieszka Stempniewicz, Piotr Ceranowicz, Wojciech Macyk, Jakub Cieszkowski, Beata Kuśnierz-Cabała, Katarzyna Gałązka, Zygmunt Warzecha

Abstract:

Objectives: There are numerous strategies for the prevention or treatment of oral mucositis. However, their effectiveness is limited and does not correspond to expectations. Recent studies have shown that obestatin exhibits a protective effect and accelerates the healing of gastrointestinal mucosa. The aim of the present study was to examine the influence of obestatin administration on oral ulcers in rats. Methods: lingual ulcers were induced by the use of acetic acid. Rats were treated twice a day intraperitoneally with saline or obestatin(4, 8, or 16 nmol/kg/dose) for five days. The study determined: lingual mucosa morphology, cell proliferation, mucosal blood flow, and mucosal pro-inflammatory interleukin-1β level(IL-1β). Results: In animals without induction of oral ulcers, treatment with obestatin was without any effect. Obestatin administration in rats with lingual ulcers increased the healing rate of these ulcers. Obestatin given at the dose of 8 or 16 nmol/kg/dose caused the strongest and similar therapeutic effect. This result was associated with a significant increase in blood flow and cell proliferation in gingival mucosa, as well as a significant decrease in IL-1β level. Conclusions: Obestatin accelerates the healing of lingual ulcers in rats. This therapeutic effect is well-correlated with an increase in blood flow and cell proliferation in oral mucosa, as well as a decrease in pro-inflammatory IL-1β levels. Obestatin is a potentially useful candidate for the prevention and treatment of oral mucositis. Acknowledgment: Agnieszka Stempniewicz acknowledges the support of InterDokMed project no. POWR.03.02.00- 00-I013/16.

Keywords: oral mucositis, ulcers, obestatin, lingual mucosa

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2489 Direct Contact Ultrasound Assisted Drying of Mango Slices

Authors: E. K. Mendez, N. A. Salazar, C. E. Orrego

Abstract:

There is undoubted proof that increasing the intake of fruit lessens the risk of hypertension, coronary heart disease, stroke, and probable evidence that lowers the risk of cancer. Proper fruit drying is an excellent alternative to make their shelf-life longer, commercialization easier, and ready-to-eat healthy products or ingredients. The conventional way of drying is by hot air forced convection. However, this process step often requires a very long residence time; furthermore, it is highly energy consuming and detrimental to the product quality. Nowadays, power ultrasound (US) technic has been considered as an emerging and promising technology for industrial food processing. Most of published works dealing with drying food assisted by US have studied the effect of ultrasonic pre-treatment prior to air-drying on food and the airborne US conditions during dehydration. In this work a new approach was tested taking in to account drying time and two quality parameters of mango slices dehydrated by convection assisted by 20 KHz power US applied directly using a holed plate as product support and sound transmitting surface. During the drying of mango (Mangifera indica L.) slices (ca. 6.5 g, 0.006 m height and 0.040 m diameter), their weight was recorded every hour until final moisture content (10.0±1.0 % wet basis) was reached. After previous tests, optimization of three drying parameters - frequencies (2, 5 and 8 minutes each half-hour), air temperature (50-55-60⁰C) and power (45-70-95W)- was attempted by using a Box–Behnken design under the response surface methodology for the optimal drying time, color parameters and rehydration rate of dried samples. Assays involved 17 experiments, including a quintuplicate of the central point. Dried samples with and without US application were packed in individual high barrier plastic bags under vacuum, and then stored in the dark at 8⁰C until their analysis. All drying assays and sample analysis were performed in triplicate. US drying experimental data were fitted with nine models, among which the Verna model resulted in the best fit with R2 > 0.9999 and reduced χ2 ≤ 0.000001. Significant reductions in drying time were observed for the assays that used lower frequency and high US power. At 55⁰C, 95 watts and 2 min/30 min of sonication, 10% moisture content was reached in 211 min, as compared with 320 min for the same test without the use of US (blank). Rehydration rates (RR), defined as the ratio of rehydrated sample weight to that of dry sample and measured, was also larger than those of blanks and, in general, the higher the US power, the greater the RR. The direct contact and intermittent US treatment of mango slices used in this work improve drying rates and dried fruit rehydration ability. This technique can thus be used to reduce energy processing costs and the greenhouse gas emissions of fruit dehydration.

Keywords: ultrasonic assisted drying, fruit drying, mango slices, contact ultrasonic drying

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2488 Back Stepping Sliding Mode Control of Blood Glucose for Type I Diabetes

Authors: N. Tadrisi Parsa, A. R. Vali, R. Ghasemi

Abstract:

Diabetes is a growing health problem in worldwide. Especially, the patients with Type 1 diabetes need strict glycemic control because they have deficiency of insulin production. This paper attempts to control blood glucose based on body mathematical body model. The Bergman minimal mathematical model is used to develop the nonlinear controller. A novel back-stepping based sliding mode control (B-SMC) strategy is proposed as a solution that guarantees practical tracking of a desired glucose concentration. In order to show the performance of the proposed design, it is compared with conventional linear and fuzzy controllers which have been done in previous researches. The numerical simulation result shows the advantages of sliding mode back stepping controller design to linear and fuzzy controllers.

Keywords: bergman model, nonlinear control, back stepping, sliding mode control

Procedia PDF Downloads 364
2487 The Implantable MEMS Blood Pressure Sensor Model With Wireless Powering And Data Transmission

Authors: Vitaliy Petrov, Natalia Shusharina, Vitaliy Kasymov, Maksim Patrushev, Evgeny Bogdanov

Abstract:

The leading worldwide death reasons are ischemic heart disease and other cardiovascular illnesses. Generally, the common symptom is high blood pressure. Long-time blood pressure control is very important for the prophylaxis, correct diagnosis and timely therapy. Non-invasive methods which are based on Korotkoff sounds are impossible to apply often and for a long time. Implantable devices can combine longtime monitoring with high accuracy of measurements. The main purpose of this work is to create a real-time monitoring system for decreasing the death rate from cardiovascular diseases. These days implantable electronic devices began to play an important role in medicine. Usually implantable devices consist of a transmitter, powering which could be wireless with a special made battery and measurement circuit. Common problems in making implantable devices are short lifetime of the battery, big size and biocompatibility. In these work, blood pressure measure will be the focus because it’s one of the main symptoms of cardiovascular diseases. Our device will consist of three parts: the implantable pressure sensor, external transmitter and automated workstation in a hospital. The Implantable part of pressure sensors could be based on piezoresistive or capacitive technologies. Both sensors have some advantages and some limitations. The Developed circuit is based on a small capacitive sensor which is made of the technology of microelectromechanical systems (MEMS). The Capacitive sensor can provide high sensitivity, low power consumption and minimum hysteresis compared to the piezoresistive sensor. For this device, it was selected the oscillator-based circuit where frequency depends from the capacitance of sensor hence from capacitance one can calculate pressure. The external device (transmitter) used for wireless charging and signal transmission. Some implant devices for these applications are passive, the external device sends radio wave signal on internal LC circuit device. The external device gets reflected the signal from the implant and from a change of frequency is possible to calculate changing of capacitance and then blood pressure. However, this method has some disadvantages, such as the patient position dependence and static using. Developed implantable device doesn’t have these disadvantages and sends blood pressure data to the external part in real-time. The external device continuously sends information about blood pressure to hospital cloud service for analysis by a physician. Doctor’s automated workstation at the hospital also acts as a dashboard, which displays actual medical data of patients (which require attention) and stores it in cloud service. Usually, critical heart conditions occur few hours before heart attack but the device is able to send an alarm signal to the hospital for an early action of medical service. The system was tested with wireless charging and data transmission. These results can be used for ASIC design for MEMS pressure sensor.

Keywords: MEMS sensor, RF power, wireless data, oscillator-based circuit

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2486 Antidiabetic and Antihyperlipaemic Effects of Aqueous Neem (Azadirachta Indica) Extract on Alloxan Diabetic Rabbits

Authors: Khalil Abdullah Ahmed Khalil, Elsadig Mohamed Ahmed

Abstract:

Extracts of various plants material capable of decreasing blood sugar have been tested in experimental animal models and their effects confirmed. Neem or Margose (Azadirachta Indica) is an indigenous plant believed to have antiviral, antifungal, antidiabetic and many other properties. This paper deals with a comparative study of the effect of aqueous Neem leaves extract alone or in combination with glibenclamide on alloxan diabetic rabbits. Administration of crude aqueous Neem extract (CANE) alone (1.5 ml/kg/day), as well as the combination of CANE (1.5 ml/kg/day) with glibenclamide (0.25 mg/kg/day) significantly, decreased (P<0.05) the concentrations of serum lipids, blood glucose and lipoprotein VLDL(very low-density lipoproteins) and LDL(low-density lipoproteins) but significantly increased (P<0.05) the concentration of HDL(high-density lipoprotein). The change was observed significantly greater when the treatment was given in combination of CANE and glibenclamid than with CANE alone.

Keywords: neem, hypoglycemic, hypolipidemic, cholesterol

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2485 Inflammatory Markers in the Blood and Chronic Periodontitis

Authors: Saimir Heta, Ilma Robo, Nevila Alliu, Tea Meta

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Background: Plasma levels of inflammatory markers are the expression of the infectious wastes of existing periodontitis, as well as of existing inflammation everywhere in the body. Materials and Methods: The study consists of the clinical part of the measurement of inflammatory markers of 23 patients diagnosed with chronic periodontitis and the recording of parental periodontal parameters of patient periodontal status: hemorrhage index and probe values, before and 7-10 days after non-surgical periodontal treatment. Results: The level of fibrinogen drops according to the categorization of disease progression, active and passive, with the biggest % (18%-30%) at the fluctuation 10-20 mg/d. Fluctuations in fibrinogen level according to the age of patients in the range 0-10 mg/dL under 40 years and over 40 years was 13%-26%, in the range 10-20 mg/dL was 26%-22%, in the 20-40 mg/dL was 9%-4%. Conclusions: Non-surgical periodontal treatment significantly reduces the level of non-inflammatory markers in the blood. Oral health significantly reduces the potential source for periodontal bacteria, with the potential of promoting thromboembolism, through interaction between thrombocytes.

Keywords: chronic periodontitis, atherosclerosis, risk factor, inflammatory markers

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2484 Blood Flow Simulations to Understand the Role of the Distal Vascular Branches of Carotid Artery in the Stroke Prediction

Authors: Muhsin Kizhisseri, Jorg Schluter, Saleh Gharie

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Atherosclerosis is the main reason of stroke, which is one of the deadliest diseases in the world. The carotid artery in the brain is the prominent location for atherosclerotic progression, which hinders the blood flow into the brain. The inclusion of computational fluid dynamics (CFD) into the diagnosis cycle to understand the hemodynamics of the patient-specific carotid artery can give insights into stroke prediction. Realistic outlet boundary conditions are an inevitable part of the numerical simulations, which is one of the major factors in determining the accuracy of the CFD results. The Windkessel model-based outlet boundary conditions can give more realistic characteristics of the distal vascular branches of the carotid artery, such as the resistance to the blood flow and compliance of the distal arterial walls. This study aims to find the most influential distal branches of the carotid artery by using the Windkessel model parameters in the outlet boundary conditions. The parametric study approach to Windkessel model parameters can include the geometrical features of the distal branches, such as radius and length. The incorporation of the variations of the geometrical features of the major distal branches such as the middle cerebral artery, anterior cerebral artery, and ophthalmic artery through the Windkessel model can aid in identifying the most influential distal branch in the carotid artery. The results from this study can help physicians and stroke neurologists to have a more detailed and accurate judgment of the patient's condition.

Keywords: stroke, carotid artery, computational fluid dynamics, patient-specific, Windkessel model, distal vascular branches

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2483 Increase of Sensitivity in 3D Suspended Polymeric Microfluidic Platform through Lateral Misalignment

Authors: Ehsan Yazdanpanah Moghadam, Muthukumaran Packirisamy

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In the present study, a design of the suspended polymeric microfluidic platform is introduced that is fabricated with three polymeric layers. Changing the microchannel plane to be perpendicular to microcantilever plane, drastically decreases moment of inertia in that direction. In addition, the platform is made of polymer (around five orders of magnitude less compared to silicon). It causes significant increase in the sensitivity of the cantilever deflection. Next, although the dimensions of this platform are constant, by misaligning the embedded microchannels laterally in the suspended microfluidic platform, the sensitivity can be highly increased. The investigation is studied on four fluids including water, seawater, milk, and blood for flow ranges from low rate of 5 to 70 µl/min to obtain the best design with the highest sensitivity. The best design in this study shows the sensitivity increases around 50% for water, seawater, milk, and blood at the flow rate of 70 µl/min by just misaligning the embedded microchannels in the suspended polymeric microfluidic platform.

Keywords: microfluidic, MEMS, biosensor, microresonator

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2482 Identifying the Mindset of Deaf Benildean Students in Learning Anatomy and Physiology

Authors: Joanne Rieta Miranda

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Learning anatomy and physiology among Deaf Non-Science major students is a challenge. They have this mindset that Anatomy and Physiology are difficult and very technical. In this study, nine (9) deaf students who are business majors were considered. Non-conventional teaching strategies and classroom activities were employed such as cooperative learning, virtual lab, Facebook live, big sky, blood typing, mind mapping, reflections, etc. Of all the activities; the deaf students ranked cooperative learning as the best learning activity. This is where they played doctors. They measured the pulse rate, heart rate and blood pressure of their partner classmate. In terms of mindset, 2 out of 9 students have a growth mindset with some fixed ideas while 7 have a fixed mindset with some growth ideas. All the students passed the course. Three out of nine students got a grade of 90% and above. The teacher was evaluated by the deaf students as very satisfactory with a mean score of 3.54. This means that the learner-centered practices in the classroom are manifested to a great extent.

Keywords: deaf students, learning anatomy and physiology, teaching strategies, learner-entered practices

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2481 Changes in Geospatial Structure of Households in the Czech Republic: Findings from Population and Housing Census

Authors: Jaroslav Kraus

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Spatial information about demographic processes are a standard part of outputs in the Czech Republic. That was also the case of Population and Housing Census which was held on 2011. This is a starting point for a follow up study devoted to two basic types of households: single person households and households of one completed family. Single person households and one family households create more than 80 percent of all households, but the share and spatial structure is in long-term changing. The increase of single households is results of long-term fertility decrease and divorce increase, but also possibility of separate living. There are regions in the Czech Republic with traditional demographic behavior, and regions like capital Prague and some others with changing pattern. Population census is based - according to international standards - on the concept of currently living population. Three types of geospatial approaches will be used for analysis: (i) firstly measures of geographic distribution, (ii) secondly mapping clusters to identify the locations of statistically significant hot spots, cold spots, spatial outliers, and similar features and (iii) finally analyzing pattern approach as a starting point for more in-depth analyses (geospatial regression) in the future will be also applied. For analysis of this type of data, number of households by types should be distinct objects. All events in a meaningful delimited study region (e.g. municipalities) will be included in an analysis. Commonly produced measures of central tendency and spread will include: identification of the location of the center of the point set (by NUTS3 level); identification of the median center and standard distance, weighted standard distance and standard deviational ellipses will be also used. Identifying that clustering exists in census households datasets does not provide a detailed picture of the nature and pattern of clustering but will be helpful to apply simple hot-spot (and cold spot) identification techniques to such datasets. Once the spatial structure of households will be determined, any particular measure of autocorrelation can be constructed by defining a way of measuring the difference between location attribute values. The most widely used measure is Moran’s I that will be applied to municipal units where numerical ratio is calculated. Local statistics arise naturally out of any of the methods for measuring spatial autocorrelation and will be applied to development of localized variants of almost any standard summary statistic. Local Moran’s I will give an indication of household data homogeneity and diversity on a municipal level.

Keywords: census, geo-demography, households, the Czech Republic

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2480 In vitro Antifungal Activity of Methanolic Extracts of Eight Various Cultivar of Persian Punica granatum L. against Candida Species

Authors: Shahindokht Bassiri-Jahromi, Mohammad Reza Pourshafie, Farzad Katiraee, Mannan Hajimahmoodi, Ehsan Mostafavi, Malihe Talebi

Abstract:

Objective: Resistance of Candida species to antifungal agents has potentially serious implications for management of infections. Candida species are now fourth common organisms isolated from hospitalized patients. It is important to increase effective therapy. In the past decade, numerous reports of treatment failures were reported. Prevention and control of these infections will require new antimicrobial agents. Plant-derived antifungal have always been a source of novel therapeutics. The aim of this study was to investigate the antifungal effect of methanolic extract of pomegranate peel and pulp against Candida species. Material and Methods: Eight cultivars of Punica granatum L. were collected from Saveh Agricultural Investigation Center in Iran. Both pomegranate pulp and peel were dried and powdered separately. The dried powders were extracted by using a soxhlet extractor. The antifungal effect of methanolic extract of pomegranate peel and pulp were determined in vitro by minimum inhibitory concentration (MIC) against five standard species of (ATCC 10231), C. parapsilosis (ATCC 22019), C. tropicalis (ATCC 750), C. glabrata (PTCC 5297), and C. kroseii (PTCC 5295). Results: Maximum inhibitions of antifungal effect were attributed to peel extract pomegranate cultivar and Candida species. The most potential antifungal inhibition among 8 different cultivars observed by sour malas, sour white peel, and sour summer extracts respectively, against five Candida strains. The antifungal activity of pulp extracts against Candida species was approximately negative. Conclusion: The use of Punica granatum peel extract has been shown to possess antifungal activities. The phytochemistry and pharmacological actions of Punica granatum peel components suggest a wide range of clinical applications for the treatment and prevention of candidiasis.

Keywords: antifungal activity, Candida species, Punica granatum L., pharmacognosy

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2479 Hemato-Biochemical Studies on Naturally Infected Camels with Trypanosomiasis

Authors: Khalid Mehmood, Riaz Hussain, Rao Z. Abbas, Tariq Abbas, Abdul Ghaffar, Ahmad J. Sabir

Abstract:

Blood born diseases such as trypanosomiasis have negative impacts on health, production and working efficiency of camels in different camel-rearing areas of the world including Pakistan. In present study blood samples were collected from camels kept at the desert condition of cholistan to estimate the prevalence of trypanosomiasis and hemato-biochemical changes in naturally infected cases. Results showed an overall 9.31% prevalence of trypanosomiasis in camels. Various clinical signs such as pyrexia, occasional shivering, inappetence, urticaria, swelling, lethargy, going down in condition and edema of pads were observed in few cases. The statistical analysis did not show significant association of age and sex with trypanosomiasis. However, results revealed significantly decreased values of total erythrocyte counts, packed cell volume, hemoglobin concentration, mean corpuscular hemoglobin concentration, serum total proteins and albumin while increased values of mean corpuscular volume was recorded in infected animals as compared to healthy. A significant (P<0.01) increased values of total leukocyte count, monocyte, lymphocyte, neutrophils, and eosinophils was recorded in infected animals. Moreover, microscopic examination of blood films obtained from naturally infected cases showed the presence of parasite and various morphological changes in cells such as stomatocyte, hyperchromasia, and polychromasia. Significantly increased values of different hepatic enzymes including alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) were also recorded.

Keywords: camel, hematological indices, serum enzymes, Trypanosomiasis

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2478 Beneficial Effect of Biotin in Combination with Canagliflozin on High Fat Diet Induced Diabetes in Rats

Authors: Rayhana Begum, HongBin Wang, Nur Alam Siddiquee, Md.Yasin Ahmed

Abstract:

Biotin treatment has significant effects on blood glucose, and pharmacological doses of biotin improve hyperglycemia. The present study was aimed to investigate the efficacy and safety of biotin in combination with canagliflozin in improving glycemic control on High Fat Diet-induced diabetes in Rats. Thirty male rats were divided into five groups (six rats /group): control, high fat diet (HFD), canagliflozin (CAG), biotin (BIO), and CAG + BIO. The treatments with CAG and /or BIO significantly reduced the body weight gain, blood glucose and HbA1c levels, whereas CAG in combination with BIO revealed greater glycemic improvement than CAG monotherapy. The treatment with CAG and /or BIO causes significant change in lipid profile and CK level while the treatment with CAG in combination with BIO showed better results as compared with CAG monotherapy. Furthermore, combination of biotin with CAG improved the pancreatic and cardiac damage when compared with other treated groups.

Keywords: canagliflozin, biotin, HbA1c, lipid profile

Procedia PDF Downloads 143
2477 Exploring the Optimum Temperature and Diet for Growth and Gastric Emptying Time of Juvenile Malabar Blood Snapper (Lutjanus malabaricus)

Authors: Sabuj Kanti Mazumder, Mazlan Abd Ghaffar, Simon Kumar Das

Abstract:

In this study, we analyzed the effects of water temperature and diet on the growth properties and gastric emptying period of juvenile Malabar blood snapper (Lutjanus malabaricus) over a 30day experimental period. Fish were collected from a local hatchery of Pulau Ketam, Selangor, Malaysia and immediately transferred to flow-through sea water system and subjected to four different temperatures (22, 26, 30, and 34 °C) and two diets (formulated pellet and shrimp). Body weight gain, food consumption, food conversion ratio, food consumption efficiency, specific growth rate, relative growth rate, daily growth rate, and gastric emptying period were significantly influenced by temperature and diet (P<0.05). The best food conversion ratio was with the shrimp group recorded at 30°C (1.33±0.08). The highest growth rate was observed in the shrimp group at 30°C (3.97±0.57% day-1), and the lowest was observed in the formulated pellet group at 22°C (1.63±0.29% day-1). No significant difference was observed between the groups subjected to temperatures of 26 and 30°C. Similarly, the lowest gastric emptying period was detected in the shrimp group at 30°C (16h), where the proportion of meal residues in the stomach decreased from 100% to less than 8% after 12h of starvation. A significantly longer gastric emptying period was observed in the formulated pellet group at 22°C (28h). Overall, the best results were observed on shrimp group subjected to a 30°C temperature. The data obtained from this study suggest that a shrimp diet fed on L. malabaricus at 30°C will optimize the commercial production of this commercially important fish species.

Keywords: aquaculture, diet, digestion rate, growth, Malabar blood snapper

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2476 Leuprolide Induced Scleroderma Renal Crisis: A Case Report

Authors: Nirali Sanghavi, Julia Ash, Amy Wasserman

Abstract:

Introduction: To the best of our knowledge, there is only one case report that found an association between leuprolide and scleroderma renal crisis (SRC). Leuprolide has been noted to cause acute renal failure in some patients. Given the close timing of the leuprolide injection and the worsening renal function in our patient, leuprolide likely caused exacerbation of lupus nephritis and SRC. Interestingly, our patient on long-term hydroxychloroquine (HCQ) with normal baseline cardiac function was found to have HCQ cardiomyopathy highlighting the need for close monitoring of HCQ toxicity. We know that some of the risk factors that are involved in HCQ induced cardiomyopathy are older age, females, increased dose and >10 years of HCQ use, and pre-existing cardiac and renal insufficiency. Case presentation: A 34-year-old African American woman with a history of overlap of systemic lupus erythematosus (SLE) and scleroderma features and class III lupus nephritis presented with severe headaches, elevated blood pressure (180/120 mmHg) and worsening creatinine levels (2.07 mg/dL). The headaches started 1 month ago after she started leuprolide injections for fibroids. She was being treated with mycophenolate mofetil 1 gm twice a day, belimumab weekly, HCQ 200mg, and prednisone 5 mg daily. She has been on HCQ since her teenage years. The examination was unremarkable except for proximal interphalangeal joint contractures in the right hand and sclerodactyly of bilateral hands, unchanged from baseline. Laboratory findings include urinalysis, which showed 3+ protein, 1+ blood, 6 red blood cells, and 14 white blood cells ruling out thrombotic microangiopathy. C3 was 32 mg/dL, C4 <5 mg/dL, and +dsDNA increased >1000. She was started on captopril and discharged once creatinine and blood pressure was controlled. She was readmitted with hypertension, hyperkalemia, worsening creatinine, nephrotic range proteinuria, complaints of chest pressure, and shortness of breath with pleuritic chest pain. Physical examination and lab findings were unchanged. She was treated with pulse dose methyl prednisone followed by taper and multiple anti-hypertensive agents, including captopril, for presumed lupus nephritis flare versus SRC. Renal biopsy was consistent with SRC and class IV lupus nephritis and was started on cyclophosphamide. While cardiac biopsy showed borderline myocarditis without necrosis and cytoplasmic vacuolization consistent with HCQ cardiomyopathy, hence HCQ was discontinued. Summary: It highlights a rare association of leuprolide causing exacerbation of lupus nephritis or SRC. Although rare, the current case reinforces the importance of close monitoring for HCQ toxicity in patients with renal insufficiency.

Keywords: leuprolide, lupus nephritis, scleroderma, SLE

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2475 Green Extraction Processes for the Recovery of Polyphenols from Solid Wastes of Olive Oil Industry

Authors: Theodora-Venetia Missirli, Konstantina Kyriakopoulou, Magdalini Krokida

Abstract:

Olive mill solid waste is an olive oil mill industry by-product with high phenolic, lipid and organic acid concentrations that can be used as a low cost source of natural antioxidants. In this study, extracts of Olea europaea (olive tree) solid olive mill waste (SOMW) were evaluated in terms of their antiradical activity and total phenolic compounds concentrations, such as oleuropein, hydroxytyrosol etc. SOMW samples were subjected to drying prior to extraction as a pretreatment step. Two drying processes, accelerated solar drying (ASD) and air-drying (AD) (at 35, 50, 70°C constant air velocity of 1 m/s), were applied. Subsequently, three different extraction methods were employed to recover extracts from untreated and dried SOMW samples. The methods include the green Microwave Assisted (MAE) and Ultrasound Assisted Extraction (UAE) and the conventional Soxhlet extraction (SE), using water and methanol as solvents. The efficiency and selectivity of the processes were evaluated in terms of extraction yield. The antioxidant activity (AAR) and the total phenolic content (TPC) of the extracts were evaluated using the DPPH assay and the Folin-Ciocalteu method, respectively. The results showed that bioactive content was significantly affected by the extraction technique and the solvent. Specifically, untreated SOMW samples showed higher performance in the yield for all solvents and higher antioxidant potential and phenolic content in the case of water. UAE extraction method showed greater extraction yields than the MAE method for both untreated and dried leaves regardless of the solvent used. The use of ultrasound and microwave assisted extraction in combination with industrially applied drying methods, such as air and solar drying, was feasible and effective for the recovery of bioactive compounds.

Keywords: antioxidant potential, drying treatment, olive mill pomace, microwave assisted extraction, ultrasound assisted extraction

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2474 The Effect of Disseminating Basic Knowledge on Radiation in Emergency Distance Learning of COVID-19

Authors: Satoko Yamasaki, Hiromi Kawasaki, Kotomi Yamashita, Susumu Fukita, Kei Sounai

Abstract:

People are susceptible to rumors when the cause of their health problems is unknown or invisible. In order for individuals to be unaffected by rumors, they need basic knowledge and correct information. Community health nursing classes use cases where basic knowledge of radiation can be utilized on a regular basis, thereby teaching that basic knowledge is important in preventing anxiety caused by rumors. Nursing students need to learn that preventive activities are essential for public health nursing care. This is the same methodology used to reduce COVID-19 anxiety among individuals. This study verifies the learning effect concerning the basic knowledge of radiation necessary for case consultation by emergency distance learning. Sixty third-year nursing college students agreed to participate in this research. The knowledge tests conducted before and after classes were compared, with the chi-square test used for testing. There were five knowledge questions regarding distance lessons. This was considered to be 5% significant. The students’ reports which describe the results of responding to health consultations, were analyzed qualitatively and descriptively. In this case study, a person living in an area not affected by radiation was anxious about drinking water and, thus, consulted with a student. The contents of the lecture were selected the minimum amount of knowledge used for the answers of the consultant; specifically hot spots, internal exposure risk, food safety, characteristics of cesium-137, and precautions for counselors. Before taking the class, the most correctly answered question by students concerned daily behavior at risk of internal exposure (52.2%). The question with the fewest correct answers was the selection of places that are likely to be hot spots (3.4%). All responses increased significantly after taking the class (p < 0.001). The answers to the counselors, as written by the students, were 'Cesium is strongly bound to the soil, so it is difficult to transfer to water' and 'Water quality test results of tap water are posted on the city's website.' These were concrete answers obtained by using specialized knowledge. Even in emergency distance learning, the students gained basic knowledge regarding radiation and created a document to utilize said knowledge while assuming the situation concretely. It was thought that the flipped classroom method, even if conducted remotely, could maintain students' learning. It was thought that setting specific knowledge and scenes to be used would enhance the learning effect. By changing the case to concern that of the anxiety caused by infectious diseases, students may be able to effectively gain the basic knowledge to decrease the anxiety of residents due to infectious diseases.

Keywords: effect of class, emergency distance learning, nursing student, radiation

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2473 Study of Mixing Conditions for Different Endothelial Dysfunction in Arteriosclerosis

Authors: Sara Segura, Diego Nuñez, Miryam Villamil

Abstract:

In this work, we studied the microscale interaction of foreign substances with blood inside an artificial transparent artery system that represents medium and small muscular arteries. This artery system had channels ranging from 75 μm to 930 μm and was fabricated using glass and transparent polymer blends like Phenylbis(2,4,6-trimethylbenzoyl) phosphine oxide, Poly(ethylene glycol) and PDMS in order to be monitored in real time. The setup was performed using a computer controlled precision micropump and a high resolution optical microscope capable of tracking fluids at fast capture. Observation and analysis were performed using a real time software that reconstructs the fluid dynamics determining the flux velocity, injection dependency, turbulence and rheology. All experiments were carried out with fully computer controlled equipment. Interactions between substances like water, serum (0.9% sodium chloride and electrolyte with a ratio of 4 ppm) and blood cells were studied at microscale as high as 400nm of resolution and the analysis was performed using a frame-by-frame observation and HD-video capture. These observations lead us to understand the fluid and mixing behavior of the interest substance in the blood stream and to shed a light on the use of implantable devices for drug delivery at arteries with different Endothelial dysfunction. Several substances were tested using the artificial artery system. Initially, Milli-Q water was used as a control substance for the study of the basic fluid dynamics of the artificial artery system. However, serum and other low viscous substances were pumped into the system with the presence of other liquids to study the mixing profiles and behaviors. Finally, mammal blood was used for the final test while serum was injected. Different flow conditions, pumping rates, and time rates were evaluated for the determination of the optimal mixing conditions. Our results suggested the use of a very fine controlled microinjection for better mixing profiles with and approximately rate of 135.000 μm3/s for the administration of drugs inside arteries.

Keywords: artificial artery, drug delivery, microfluidics dynamics, arteriosclerosis

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2472 Reduced Glycaemic Impact by Kiwifruit-Based Carbohydrate Exchanges Depends on Both Available Carbohydrate and Non-Digestible Fruit Residue

Authors: S. Mishra, J. Monro, H. Edwards, J. Podd

Abstract:

When a fruit such as kiwifruit is consumed its tissues are released from the physical /anatomical constraints existing in the fruit. During digestion they may expand several-fold to achieve a hydrated solids volume far greater than the original fruit, and occupy the available space in the gut, where they surround and interact with other food components. Within the cell wall dispersion, in vitro digestion of co-consumed carbohydrate, diffusion of digestion products, and mixing responsible for mass transfer of nutrients to the gut wall for absorption, were all retarded. All of the foregoing processes may be involved in the glycaemic response to carbohydrate foods consumed with kiwifruit, such as breakfast cereal. To examine their combined role in reducing the glycaemic response to wheat cereal consumed with kiwifruit we formulated diets containing equal amounts of breakfast cereal, with the addition of either kiwifruit, or sugars of the same composition and quantity as in kiwifruit. Therefore, the only difference between the diets was the presence of non-digestible fruit residues. The diet containing the entire disperse kiwifruit significantly reduced the glycaemic response amplitude and the area under the 0-120 min incremental blood glucose response curve (IAUC), compared with the equicarbohydrate diet containing the added kiwifruit sugars. It also slightly but significantly increased the 120-180 min IAUC by preventing a postprandial overcompensation, indicating improved homeostatic blood glucose control. In a subsequent study in which we used kiwifruit in a carbohydrate exchange format, in which the kiwifruit carbohydrate partially replaced breakfast cereal in equal carbohydrate meals, the blood glucose was further reduced without a loss of satiety, and with a reduction in insulin demand. The results show that kiwifruit may be a valuable component in low glycaemic impact diets.

Keywords: carbohydrate, digestion, glycaemic response, kiwifruit

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2471 Comprehensive Ultrasonography During Low-flow Bypass in Patients with Symptomatic Internal Carotid Artery (ICA) Occlusion

Authors: G. K. Guseynova, V. V. Krylov, L. T. Khamidova, N. A. Polunina, V. A. Lukyanchikov

Abstract:

The report presents complex ultrasound diagnostics in patients with symptomatic steno-occlusive lesions of extra- and intracranial branches of brachiocephalic arteries (BCA). The tasks and possibilities of ultrasound diagnostics at different stages of treatment of patients with symptomatic occlusion of internal carotid artery (ICA) are covered in detail; qualitative and quantitative characteristics of blood flow; parameters of the wall and lumen of the main arteries of the head; methods of ultrasound examination of indirect assessment of the functional status are presented. Special attention is paid to the description of indicators that are predictors of the consistency of formed extra-intracranial low-flow shunts, examples of functioning and failed anastomoses are analyzed.

Keywords: CBF, cerebral blood flow; CTA, external carotid artery; ICA, internal carotid artery; MCA, middle cerebral artery; MRA, magnetic resonance angiography; OEF, oxygen extraction fraction; TIA, transient ischaemic attack, ultrasound, low-flow bypass, anastomoses

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2470 Diabetes Mellitus and Blood Glucose Variability Increases the 30-day Readmission Rate after Kidney Transplantation

Authors: Harini Chakkera

Abstract:

Background: Inpatient hyperglycemia is an established independent risk factor among several patient cohorts with hospital readmission. This has not been studied after kidney transplantation. Nearly one-third of patients who have undergone a kidney transplant reportedly experience 30-day readmission. Methods: Data on first-time solitary kidney transplantations were retrieved between September 2015 to December 2018. Information was linked to the electronic health record to determine a diagnosis of diabetes mellitus and extract glucometeric and insulin therapy data. Univariate logistic regression analysis and the XGBoost algorithm were used to predict 30-day readmission. We report the average performance of the models on the testing set on five bootstrapped partitions of the data to ensure statistical significance. Results: The cohort included 1036 patients who received kidney transplantation, and 224 (22%) experienced 30-day readmission. The machine learning algorithm was able to predict 30-day readmission with an average AUC of 77.3% (95% CI 75.30-79.3%). We observed statistically significant differences in the presence of pretransplant diabetes, inpatient-hyperglycemia, inpatient-hypoglycemia, and minimum and maximum glucose values among those with higher 30-day readmission rates. The XGBoost model identified the index admission length of stay, presence of hyper- and hypoglycemia and recipient and donor BMI values as the most predictive risk factors of 30-day readmission. Additionally, significant variations in the therapeutic management of blood glucose by providers were observed. Conclusions: Suboptimal glucose metrics during hospitalization after kidney transplantation is associated with an increased risk for 30-day hospital readmission. Optimizing the hospital blood glucose management, a modifiable factor, after kidney transplantation may reduce the risk of 30-day readmission.

Keywords: kidney, transplant, diabetes, insulin

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2469 Bacteremia Caused by Nontoxigenic Vibrio cholerae in an Immunocompromised Patient in Istanbul, Turkey

Authors: Fatma Koksal Çakirlar, Si̇nem Ozdemir, Selcan Akyol, Revazi̇ye Gulesen, Murat Gunaydin, Nevri̇ye Gonullu, Belkis Levent, Nuri̇ Kiraz

Abstract:

Vibrio cholerae O1 and O139 are the causative agent of epidemic or pandemic cholera. V. cholerae O1 is generally accepted as a non-invasive enterotoxigenic organism causing gastroenteritis of various severities. Non-O1 V. cholerae can cause small outbreaks of diarrhea due to consumption of contaminated food and water. Particularly, the patients with achlorydria have a risk for vibrio infections. There are numerous case reports of bacteremia caused by vibrio in patients with predisposing conditions like cirrhosis, nephrotic syndrome, diabetes, hematologic malignancy, gastrectomy, and AIDS. We described in this study the first case of nontoxigenic, non-01/non-O139 V. cholerae isolated from the blood culture of a 77-year-old female patient with hipertension, diabetes, coronary artery disease, gout and about 9 years ago migrated breast cancer history. The patient with complaints of shortness of breath, fever and malaise admitted to our emergency clinic were evaluated. There was no diarrhea or abdominal symptoms in the patient. No growth in her urine culture, but blood culture (BACTEC 9120 system, Becton Dickinson, USA) was positive for non-01/non-O139 V. cholerae that was identified by conventional methods and Phoenix automated system (BD Diagnostic Systems, Sparks, MD). It does not secrete the cholera toxin. The agglutination test was negative with polyvalent O1 antisera and O139 antiserum. Empirically ceftriaxone was administered to the patient and she was discharged with improvement in general condition. In this study we report bacteremia by non-01/non-O139 V. cholerae that is rare in the worldwide and first in Turkey.

Keywords: bacteremia, blood culture, immunocompromised patient, Non-O1 vibrio cholerae

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2468 Long-Term Cohort of Patients with Beta Thalassemia; Prevailing Role of Serum Ferritin Levels in Hypocalcemia and Growth Retardation

Authors: Shervin Rashidinia, Sara Shahmoradi, Seyyed Shahin Eftekhari, Mohsen Talebizadeh, Mohammad Saleh Sadeghi

Abstract:

Background: Beta-thalassemia Major (BTM) is a kind of hereditary hemolytic anemia which depended on regular monthly blood transfusion. However, iron deposition into the organs leads to multi-organ damage. The present study is the first study which aimed to evaluate the average of five-years serum ferritin level and compared by the prevalence of short stature and hypocalcemia. Materials/Methods: A cross-sectional retrospective study which a total of 140 patients with beta-thalassemia who were referred to Qom Thalassemia Clinic between February 2011 and July 2016 were enrolled to be reviewed. The exclusion criteria were consisting of incomplete medical records, diagnosis less than 2-years-ago and the blood transfusion less than every 4 weeks. The data including age, gender, weight, height, age of initial blood transfusion, age of initial chelation therapy, ferritin, and calcium were collected and analysis by SPSS version 24. Results: A total of 140 patients were enrolled. Of them, 75 (53.4%) were female. The mean age of the patients was 13.4±4.6 years.The mean age of initial diagnosis was 20.2±7.4 months. Hypocalcemia and short stature were occurred in 41 (29.3%) and 37 (26.4%) patients, respectively. The mean five-years serum ferritin level was significantly higher in the patients with short stature and hypocalcemia (P<0.0001). However, rise in serum ferritin level significantly increases the risk of short-stature and hypocalcemia (1.0004- and 1.0029 fold, respectively). Conclusion: We demonstrated that prevalence of short stature and hypocalcemia were significantly higher in the BTM.However, ferritin significantly increases the risk of short stature and hypocalcemia.

Keywords: beta-thalassemia, ferritin, growth retardation, hypocalcemia

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