Search results for: metabolic disease
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4215

Search results for: metabolic disease

4035 Elucidation of the Sequential Transcriptional Activity in Escherichia coli Using Time-Series RNA-Seq Data

Authors: Pui Shan Wong, Kosuke Tashiro, Satoru Kuhara, Sachiyo Aburatani

Abstract:

Functional genomics and gene regulation inference has readily expanded our knowledge and understanding of gene interactions with regards to expression regulation. With the advancement of transcriptome sequencing in time-series comes the ability to study the sequential changes of the transcriptome. This method presented here works to augment existing regulation networks accumulated in literature with transcriptome data gathered from time-series experiments to construct a sequential representation of transcription factor activity. This method is applied on a time-series RNA-Seq data set from Escherichia coli as it transitions from growth to stationary phase over five hours. Investigations are conducted on the various metabolic activities in gene regulation processes by taking advantage of the correlation between regulatory gene pairs to examine their activity on a dynamic network. Especially, the changes in metabolic activity during phase transition are analyzed with focus on the pagP gene as well as other associated transcription factors. The visualization of the sequential transcriptional activity is used to describe the change in metabolic pathway activity originating from the pagP transcription factor, phoP. The results show a shift from amino acid and nucleic acid metabolism, to energy metabolism during the transition to stationary phase in E. coli.

Keywords: Escherichia coli, gene regulation, network, time-series

Procedia PDF Downloads 344
4034 The Burden of Leptospirosis in Terms of Disability Adjusted Life Years in a District of Sri Lanka

Authors: A. M. U. P. Kumari, Vidanapathirana. J., Amarasekara J., Karunanayaka L.

Abstract:

Leptospirosis is a zoonotic infection with significant morbidity and mortality. As an occupational disease, it has become a global concern due to its disease burden in endemic countries and rural areas. The aim of this study was to assess disease burden in terms of DALYs of leptospirosis. A hospital-based descriptive cross-sectional study was conducted using 450 clinically diagnosed leptospirosis patients admitted to base and above hospitals in Monaragala district, Sri Lanka, using a pretested interviewer administered questionnaire. The patients were followed up till normal day today life after discharge. Estimation of DALYs was done using laboratory confirmed leptospirosis patients. Leptospirosis disease burden in the Monaragala district was 44.9 DALYs per 100,000 population which includes 33.18 YLLs and 10.9 YLDs. The incidence of leptospirosis in the Monaragala district during the study period was 59.8 per 100,000 population, and the case fatality rate (CFR) was 1.5% due to delay in health seeking behaviour; 75% of deaths were among males due to multi organ failure. The disease burden of leptospirosis in the Moneragala district was significantly high, and urgent efforts to control and prevent leptospirosis should be a priority.

Keywords: human leptospirosis, disease burden, disability adjusted life Years, Sri Lanka

Procedia PDF Downloads 213
4033 Ecology, Value-Form and Metabolic Rift: Conceptualizing the Environmental History of the Amazon in the Capitalist World-System (19th-20th centuries)

Authors: Santiago Silva de Andrade

Abstract:

In recent decades, Marx's ecological theory of the value-form and the theory of metabolic rift have represented fundamental methodological innovations for social scientists interested in environmental transformations and their relationships with the development of the capital system. However, among Latin American environmental historians, such theoretical and methodological instruments have been used infrequently and very cautiously. This investigation aims to demonstrate how the concepts of metabolic rift and ecological value-form are important for understanding the environmental, economic and social transformations in the Amazon region between the second half of the 19th century and the end of the 20th century. Such transformations manifested themselves mainly in two dimensions: the first concerns the link between the manufacture of tropical substances for export and scientific developments in the fields of botany, chemistry and agriculture. This link was constituted as a set of social, intellectual and economic relations that condition each other, configuring an asymmetrical field of exchanges and connections between the demands of the industrialized world - personified in scientists, naturalists, businesspeople and bureaucrats - and the agencies of local social actors, such as indigenous people, riverside dwellers and quilombolas; the second dimension concerns the imperative link between the historical development of the capitalist world-system and the restructuring of the natural world, its landscapes, biomes and social relations, notably in peripheral colonial areas. The environmental effects of capitalist globalization were not only seen in the degradation of exploited environments, although this has been, until today, its most immediate and noticeable aspect. There was also, in territories subject to the logic of market accumulation, the reformulation of patterns of authority and institutional architectures, such as property systems, political jurisdictions, rights and social contracts, as a result of the expansion of commodity frontiers between the 16th and 21st centuries. . This entire set of transformations produced impacts on the ecological landscape of the Amazon. This demonstrates the need to investigate the histories of local configurations of power, spatial and ecological - with their institutions and social actors - and their role in structuring the capitalist world-system , under the lens of the ecological theory of value-form and metabolic rift.

Keywords: amazon, ecology, form-value, metabolic rift

Procedia PDF Downloads 39
4032 Attenuation of Amyloid beta (Aβ) (1-42)-Induced Neurotoxicity by Luteolin

Authors: Dona Pamoda W. Jayatunga, Veer Bala Gupta, Eugene Hone, Ralph N. Martins

Abstract:

Being a neurodegenerative disorder, Alzheimer’s disease (AD) affects a majority of the elderly demented worldwide. The key risk factors for AD are age, metabolic syndrome, allele status of APOE gene, head injuries and lifestyle. The progressive nature of AD is characterized by symptoms of multiple cognitive deficits exacerbated over time, leading to death within a decade from clinical diagnosis. However, it is revealed that AD originates via a prodromal phase that spans from one to few decades before symptoms first manifest. The key pathological hallmarks of AD brains are deposition of amyloid beta (Aβ) plaques and neurofibrillary tangles (NFT). However, the yet unknown etiology of the disease fails to distinguish mitochondrial dysfunction between a cause or an outcome. The absence of early diagnosis tools and definite therapies for AD have permitted recruits of nutraceutical-based approaches aimed at reducing the risk of AD by modulating lifestyle or be used as preventive tools during AD prodromal state before widespread neurodegeneration begins. The objective of the present study was to investigate beneficial effects of luteolin, a plant-based flavone compound, against AD. The neuroprotective effects of luteolin on amyloid beta (Aβ) (1-42)-induced neurotoxicity was measured using cultured human neuroblastoma BE(2)-M17 cells. After exposure to 20μM Aβ (1-42) for 48 h, the neuroblastoma cells exhibited marked apoptotic death. Co-treatment of 20μM Aβ (1-42) with luteolin (0.5-5μM) significantly protected the cells against Aβ (1-42)-induced toxicity, as assessed by the MTS [3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2(4sulfophenyl)-2H-tetrazolium, inner salt; MTS] reduction assay and the lactate dehydrogenase (LDH) cell death assay. The results suggest that luteolin prevents Aβ (1-42)-induced apoptotic neuronal death. However, further studies are underway to determine its protective mechanisms in AD including the activity against tau hyperphosphorylation and mitochondrial dysfunction.

Keywords: Aβ (1-42)-induced toxicity, Alzheimer’s disease, luteolin, neuroblastoma cells

Procedia PDF Downloads 128
4031 The Last of Centuries Old Cardamom Farming in Eastern Nepal: Crop Disease, Coping Strategies and Institutional Innovation

Authors: K. C. Sony

Abstract:

This paper investigates the coping strategies of households confronting disease in large cardamom (Amomum Subulatum Roxb.) in eastern Nepal. Cardamom farmers draw on various coping strategies to reduce the impact of crop disease in their livelihoods. Yet farmers face tremendous decline in production with a constant effort for revival. Past evidences provides dearth of information about coping strategies employed by farmers and institutional intervention to combat disease. Using factual data from Ilam district, and conducting a political economic analysis, this research addresses the gap by 1) understanding the impact of crop disease in farmers’ livelihoods, 2) identifying the coping strategies adopted by farmers and, 3) examining the existing institutional arrangements to address the disease. Coping strategies vary by household’s status defined by size of land, alternative income, and access to supporting institutions. Measures adopted are burning the cardamom field, changing land use pattern, diversifying crops, and visiting institutions for support. The local government’s support is limited to providing trainings and producing new varieties of cardamom. During crisis, farmers expect institutions to help revive the cardamom production, despite customary practice to combat disease. To retain and improve the livelihoods of farmers, there needs to be institutional innovation at the community level and policies that endorse immediate and sustainable support during hazards.

Keywords: cardamom, coping strategy, disease, institutions, Nepal

Procedia PDF Downloads 266
4030 Effect of Exercise Training on Body Composition and Metabolic Profile in Older Adults during Cancer Treatment

Authors: Adeline Fontvieille, Hugo Parent-Roberge, Marie-France Langlois, Tamas Fulop, Michel Pavic, Eleonor Riesco

Abstract:

Introduction: Total lean body mass is reduced during cancer treatment. This loss is called cancer cachexia and is accompanied by a progressive loss of fat mass. In older adults, these body composition changes can have a larger impact on metabolic health, physical autonomy, and cancer survival. Although currently untreatable, exercise training could reduce these effects. Hence, the objective of this pilot study is to investigate if 12 weeks of exercise training during cancer treatment can mitigate the loss of muscle mass and fat mass in older adults. Methods: A total of 40 older adults (65-80 years) with an ongoing treatment for a curable cancer are currently recruited and randomised in two groups: 1) Combined training (EX, n=20) and 2) Control group (CON, n=20). All variables are measured before and after 12 weeks of intervention: Anthropometry (weight, height, body mass index), body composition (total fat mass, visceral adipose tissue, total and appendicular muscle mass; DXA), metabolic profile (HDL-C and LDL-C, triglycerides, glucose and insulin levels). Results: Preliminary analyses revealed no impact of exercise training on appendicular muscle mass (p=0,31) and fat mass (p=0,31). Furthermore, total body weight, waist circumference, HDL-cholesterol, LDL-cholesterol, glucose and insulin levels remained unchanged (all p ≥ 0.79) after 12 weeks of training. However, statistical analyses revealed that triglyceride levels slightly increased (p=0.03), irrespective of the group. Conclusion: Preliminary analyses did not reveal any impact of aerobic and resistance exercise training on body composition in oncogeriatric patients. Furthermore, exercise training seems not efficient to prevent the cancer treatment-related triglyceride levels increase.

Keywords: muscle mass, fat mass, metabolic profile, combined training, aging, cancer

Procedia PDF Downloads 334
4029 An Analysis System for Integrating High-Throughput Transcript Abundance Data with Metabolic Pathways in Green Algae

Authors: Han-Qin Zheng, Yi-Fan Chiang-Hsieh, Chia-Hung Chien, Wen-Chi Chang

Abstract:

As the most important non-vascular plants, algae have many research applications, including high species diversity, biofuel sources, adsorption of heavy metals and, following processing, health supplements. With the increasing availability of next-generation sequencing (NGS) data for algae genomes and transcriptomes, an integrated resource for retrieving gene expression data and metabolic pathway is essential for functional analysis and systems biology in algae. However, gene expression profiles and biological pathways are displayed separately in current resources, and making it impossible to search current databases directly to identify the cellular response mechanisms. Therefore, this work develops a novel AlgaePath database to retrieve gene expression profiles efficiently under various conditions in numerous metabolic pathways. AlgaePath, a web-based database, integrates gene information, biological pathways, and next-generation sequencing (NGS) datasets in Chlamydomonasreinhardtii and Neodesmus sp. UTEX 2219-4. Users can identify gene expression profiles and pathway information by using five query pages (i.e. Gene Search, Pathway Search, Differentially Expressed Genes (DEGs) Search, Gene Group Analysis, and Co-Expression Analysis). The gene expression data of 45 and 4 samples can be obtained directly on pathway maps in C. reinhardtii and Neodesmus sp. UTEX 2219-4, respectively. Genes that are differentially expressed between two conditions can be identified in Folds Search. Furthermore, the Gene Group Analysis of AlgaePath includes pathway enrichment analysis, and can easily compare the gene expression profiles of functionally related genes in a map. Finally, Co-Expression Analysis provides co-expressed transcripts of a target gene. The analysis results provide a valuable reference for designing further experiments and elucidating critical mechanisms from high-throughput data. More than an effective interface to clarify the transcript response mechanisms in different metabolic pathways under various conditions, AlgaePath is also a data mining system to identify critical mechanisms based on high-throughput sequencing.

Keywords: next-generation sequencing (NGS), algae, transcriptome, metabolic pathway, co-expression

Procedia PDF Downloads 382
4028 A Basic Understanding of Viral Disease and Education Level Influences Disease Risk Perception, Disease Severity Perception, and Mask Wearing Behavior During the COVID-19 Pandemic

Authors: Ilse Kreme

Abstract:

To the best of this author’s knowledge, no studies have been identified on the connection between a refusal to engage in health-protective behaviors and a basic understanding of viral biology among community college students, faculty, and staff during the COVID-19 pandemic. Lack of scientific knowledge could prevent understanding of why these behaviors are important to prevent the community spread of COVID-19, even when they are not shown to offer much individual protection. In this study, a possible correlation was examined between a basic knowledge level of viral disease that comes from having taken a college biology course and disease perceptions of COVID-19. In particular, disease risk perception, disease severity percept and mask-wearing behaviors were examined as they correlated with having taken an undergraduate biology course. The effect of covariates of age, gender, and education level were investigated along with the main dependent variables. A representative sample of the population included students, faculty, and staff at Paradise Valley Community College (PVCC) in Phoenix, Arizona. Participants were recruited by an email sent to all students, faculty, and staff at PVCC using an all-college email distribution. Disease risk and severity perception were assessed with the Brief Illness Perception Questionnaire 5 (BIP-Q5), which was modified to include questions measuring participant age, education level, and whether they took or ever took a college biology course. Two additional questions measured compliance of willingness to wear a face mask. The results showed an effect of gender on mask-wearing behavior and a correlation between having taken a biology course and disease severity perception. No differences were seen in mask-wearing behavior and disease risk perception as a result of having taken a biology course. These findings suggest that taking an undergraduate biology course leads to a greater awareness of COVID-19 disease severity through an understanding of the basic biological principles of viral disease transmission. The results can be used to modify existing health education strategies. Further research is needed on how to best reach target audiences in all education brackets.

Keywords: COVID-19, education, gender, mask wearing, disease risk perception, disease severity perception

Procedia PDF Downloads 79
4027 Subjective Well-Being in Individuals Diagnosed with an Autoimmune Disease: Resilience, and Rumination as Moderating Factors

Authors: Renae McNair

Abstract:

Subjective well-being levels were assessed in individuals diagnosed with an autoimmune disease. The current exploratory analysis sought to examine two factors that impact subjective well-being in individuals diagnosed with a chronic health condition. The two factors, resilience, and rumination, were assessed as possible moderators in self-reported levels of subjective well-being were measured. The importance of understanding the psychological state of perceived well-being in an individual diagnosed with an autoimmune disease is important given the impact of the level of subjective well-being on life longevity. In previous research, higher levels of subjective well-being are correlated with longer life longevity, including those individuals who have been diagnosed with an autoimmune disease. Conversely, individuals who report higher levels of negative affect have a shorter length of life longevity. According to the Center for Disease Control (CDC) and a report from the National Health Council, currently, 8-10% of individuals in the United States have been diagnosed with at least one autoimmune disease. Although treatment plans are in place to help manage the physical effects of disease, the psychological state of the person impacts life longevity. Resilience and rumination impact subjective well-being as an outcome in individuals diagnosed with an autoimmune disease. Resilience is the ability to adjust or adapt effectively and positively to unfavorable life conditions or events. Resilience acts as a protective factor in life, allowing those who face adversity to successfully adapt, regardless of the health diagnosis. Rumination is the worry or dwelling on the negative aspects of a given situation. Rumination interrupts the adaptive response, leading to a decrease in well-being. The relationship between resilience and subjective well-being were examined correlated with higher levels of resilience and higher levels of self-reported subjective well-being.

Keywords: subjective well-being, rumination, resilience, autoimmune disease

Procedia PDF Downloads 229
4026 Effective Factors on Self-Care in Women with Osteoporosis: A Study with Content Analysis Approach

Authors: Arezoo Fallahi, Siamak Derakhshan, Parvaneh Taymoori, Babak Nematshahrbabaki

Abstract:

Background: Osteoporosis, the most common metabolic bone disease, is an important health care issue. Not only the cost of disease is high but also is one of the causes of disability and mortality and effect on quality of life. Although self-care is effective on disease, s control and treatment but still effective factors on self-care of patient, s viewpoint have not been survey. The aim of this study was to explore effective factors on self-care in women with osteoporosis. Materials and methods: This study was done by conventional content analysis approach in year 2014. Through purposeful sampling 15 women referred to bone mass densitometry centers participated in this study. Inclusion criteria were: Women older than 50 years old with osteoporosis, final diagnosis of osteoporosis for over six –month period, T-score index below -2.5 (lower back or hip), drug use by patients with a physician’s prescription, ability in speaking and attending to participate in the study. Data was collected by face to face and group semi-structure deep interviews and analyzed via content analysis method. To support of rigor of data, criteria credibility, confirmability and transferability were used. Results: during data analysis five categories developed: “hope and disability in the face of illness”, “mutual roles of physician”, “role of family” and “administrative centers and organizations”. To perform self-care behaviors, the participations of this study emphasized on pay attention to their own healthy, regarding patients' rights by physician, pay attention to women's health by men, and the role of media especially radio and television. Conclusion: the finding of the study showed that women’s responsibility with osteoporosis for their health is not a factor but it is multifactorial. Increasing life expectancy in patients, attention to patients needs by physician, increasing health promotion programs in the media and enhancing role of family may provide conditions and infrastructure to empowerment women in doing self-care behavior.

Keywords: women, osteoporosis, self-care, content analysis

Procedia PDF Downloads 439
4025 The Effect of Non-Surgical Periodontal Therapy on Metabolic Control in Children

Authors: Areej Al-Khabbaz, Swapna Goerge, Majedah Abdul-Rasoul

Abstract:

Introduction: The most prevalent periodontal disease among children is gingivitis, and it usually becomes more severe in adolescence. A number of intervention studies suggested that resolution of periodontal inflammation can improve metabolic control in patients diagnosed with diabetes mellitus. Aim: to assess the effect of non-surgical periodontal therapy on glycemic control of children diagnosed with diabetes mellitus. Method: Twenty-eight children diagnosed with diabetes mellitus were recruited with established diagnosis diabetes for at least 1 year. Informed consent and child assent form were obtained from children and parents prior to enrolment. The dental examination for the participants was performed on the same week directly following their annual medical assessment. All patients had their glycosylated hemoglobin (HbA1c%) test one week prior to their annual medical and dental visit and 3 months following non-surgical periodontal therapy. All patients received a comprehensive periodontal examination The periodontal assessment included clinical attachment loss, bleeding on probing, plaque score, plaque index and gingival index. All patients were referred for non-surgical periodontal therapy, which included oral hygiene instruction and motivation followed by supra-gingival and subg-ingival scaling using ultrasonic and hand instruments. Statistical Analysis: Data were entered and analyzed using the Statistical Package for Social Science software (SPSS, Chicago, USA), version 18. Statistical analysis of clinical findings was performed to detect differences between the two groups in term of periodontal findings and HbA1c%. Binary logistic regression analysis was performed in order to examine which factors were significant in multivariate analysis after adjusting for confounding between effects. The regression model used the dependent variable ‘Improved glycemic control’, and the independent variables entered in the model were plaque index, gingival index, bleeding %, plaque Statistical significance was set at p < 0.05. Result: A total of 28 children. The mean age of the participants was 13.3±1.92 years. The study participants were divided into two groups; Compliant group (received dental scaling) and non-complaints group (received oral hygiene instructions only). No statistical difference was found between compliant and non-compliant group in age, gender distribution, oral hygiene practice and the level of diabetes control. There was a significant difference between compliant and non-compliant group in term of improvement of HBa1c before and after periodontal therapy. Mean gingival index was the only significant variable associated with improved glycemic control level. In conclusion, this study has demonstrated that non-surgical mechanical periodontal therapy can improve HbA1c% control. The result of this study confirmed that children with diabetes mellitus who are compliant to dental care and have routine professional scaling may have better metabolic control compared to diabetic children who are erratic with dental care.

Keywords: children, diabetes, metabolic control, periodontal therapy

Procedia PDF Downloads 130
4024 Soluble CD36 and Cardiovascular Risk in Middle-Aged Subjects

Authors: Mohammad Alkhatatbeh, Nehad Ayoub, Nizar Mhaidat, Nesreen Saadeh, Lisa Lincz

Abstract:

CD36 is involved in the development of atherosclerosis by enhancing macrophage endocytosis of oxidized-low density lipoproteins and foam cell formation. Soluble CD36 (sCD36) was found to be elevated in type 2 diabetic patients and was supposed to act as a marker of insulin resistance and atherosclerosis. In young subjects, sCD36 was associated with cardiovascular risk factors including obesity and hypertriglyceridemia. This study was conducted to further investigate the relationship between plasma sCD36 and cardiovascular risk factors among middle-aged patients with metabolic syndrome (MetS) and healthy controls. SCD36 concentrations were determined by enzyme-linked immunosorbent assays (ELISA) for 41 patients with MetS and 36 healthy controls. Data for other variables were obtained from patients' medical records. SCD36 concentrations were relatively low compared to most other studies and were not significantly different between the MetS group and controls (P-value=0.17). SCD36 was also not correlated with age, body mass index, glucose, lipid profile, serum electrolytes and blood counts. SCD36 was not significantly different between subjects with obesity, hyperglycemia, dyslipidemia, hypertension or cardiovascular disease and those without these abnormalities (P-value > 0.05). The inconsistency between results reported in this study and other studies may be unique to the study population or be a result of the lack of a reliable standardized method for determining absolute sCD36 concentrations. However, further investigations are required to assess CD36 tissue expression in the study population and to assess the accuracy of various commercially available sCD36 ELISA kits. Thus, the availability of a standardized simple sCD36 ELISA that could be performed in any basic laboratory would be more favorable to the specialized flow cytometry methods that detect CD36+ microparticles if it was to be used as a biomarker.

Keywords: metabolic syndrome, CD36, cardiovascular risk, obesity, type 2 diabetes mellitus

Procedia PDF Downloads 245
4023 Manual Dexterity in Patients with Motor Neuron Disease

Authors: Magdalena Barbara Kaziuk, Ilona Hubner, Jacek Hubner, Slawomir Kroczka

Abstract:

Background: The motor neuron disease is a progressive neurodegenerative disease causing malfunction. Irrespective of the form of the disease and its onset always leads to the worsening of the quality of life, with patients usually depending on the family. Materials and methods: The study included 20 persons (5 females, 15 males, aged 65,5 ± 20 years) with clinically certain or probable diagnosis of the motor neuron disease. Patients were examined three times in the period of six months. The diagnosis was established based on the criteria of El Escorial. Manual dexterity was assessed using the test of the card Rene Zazzo and the test of shading in with lines Mira Stambak. Results: All patients achieved unsatisfactory results in Rene Zazzo’s test of the card and most of the patients (60%) in Mira Stambak’s test of shading with lines. Significantly higher test results were achieved for Rene Zazzo’s test and lower test results for Mira Stambak’s test in consecutive measurements. Conclusions: Impairment of manual dexterity is present already at the moment of diagnosing the disease and is growing significantly during its course. The quality of life for MND patients undergoes gradual deterioration as a result of the malfunction.

Keywords: manual dexterity, motor neuron disease, quality of life, malfunction

Procedia PDF Downloads 317
4022 Fuzzy Inference System for Diagnosis of Malaria

Authors: Purnima Pandit

Abstract:

Malaria remains one of the world’s most deadly infectious disease and arguably, the greatest menace to modern society in terms of morbidity and mortality. To choose the right treatment and to ensure a quality of life suitable for a specific patient condition, early and accurate diagnosis of malaria is essential. It reduces transmission of disease and prevents deaths. Our work focuses on designing an efficient, accurate fuzzy inference system for malaria diagnosis.

Keywords: fuzzy inference system, fuzzy logic, malaria disease, triangular fuzzy number

Procedia PDF Downloads 271
4021 Serum Neurotrophins in Different Metabolic Types of Obesity

Authors: Irina M. Kolesnikova, Andrey M. Gaponov, Sergey A. Roumiantsev, Tatiana V. Grigoryeva, Alexander V. Laikov, Alexander V. Shestopalov

Abstract:

Background. Neuropathy is a common complication of obesity. In this regard, the content of neurotrophins in such patients is of particular interest. Neurotrophins are the proteins that regulate neuron survival and neuroplasticity and include brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF). However, the risk of complications depends on the metabolic type of obesity. Metabolically unhealthy obesity (MUHO) is associated with a high risk of complications, while this is not the case with metabolically healthy obesity (MHO). Therefore, the aim of our work was to study the effect of the obesity metabolic type on serum neurotrophins levels. Patients, materials, methods. The study included 134 healthy donors and 104 obese patients. Depending on the metabolic type of obesity, the obese patients were divided into subgroups with MHO (n=40) and MUHO (n=55). In the blood serum, the concentration of BDNF and NGF was determined. In addition, the content of adipokines (leptin, asprosin, resistin, adiponectin), myokines (irisin, myostatin, osteocrin), indicators of carbohydrate, and lipid metabolism were measured. Correlation analysis revealed the relationship between the studied parameters. Results. We found that serum BDNF concentration was not different between obese patients and healthy donors, regardless of obesity metabolic type. At the same time, in obese patients, there was a decrease in serum NGF level versus control. A similar trend was characteristic of both MHO and MUHO. However, MUHO patients had a higher NGF level than MHO patients. The literature indicates that obesity is associated with an increase in the plasma concentration of NGF. It can be assumed that in obesity, there is a violation of NGF storage in platelets, which accelerates neurotrophin degradation. We found that BDNF concentration correlated with irisin levels in MUHO patients. Healthy donors had a weak association between NGF and VEGF levels. No such association was found in obese patients, but there was an association between NGF and leptin concentrations. In MHO, the concentration of NHF correlated with the content of leptin, irisin, osteocrin, insulin, and the HOMA-IR index. But in MUHO patients, we found only the relationship between NGF and adipokines (leptin, asprosin). It can be assumed that in patients with MHO, the replenishment of serum NGF occurs under the influence of muscle and adipose tissue. In the MUHO patients only the effect of adipose tissue on NGF was observed. Conclusion. Obesity, regardless of metabolic type, is associated with a decrease in serum NGF concentration. We showed that muscle and adipose tissues make a significant contribution to the serum NGF pool in the MHO patients. In MUHO there is no effect of muscle on the NGF level, but the effect of adipose tissue remains.

Keywords: neurotrophins, nerve growth factor, NGF, brain-derived neurotrophic factor, BDNF, obesity, metabolically healthy obesity, metabolically unhealthy obesity

Procedia PDF Downloads 79
4020 The Role of Physical Activity on Some Factors Affecting Cardiovascular Disease

Authors: M. J. Pourvaghar, M. E. Bahram, Sh. Khoshemehry

Abstract:

Hyperlipidemia or an increase in blood lipids is a condition that has been rising, especially during the last decade, with the advancement of the life-span of the car, as an important disease. In fact, it is one of the complications of industrial life and semi-industrial. Hyperlipidemia alone is not a disease, but it is recognized as an important risk factor for coronary artery disease. The methodology of this review article is the use of research to provide the best solution for physical activity and exercise in relation to lowering blood lipids and lowering blood pressure. Also, factors that contribute to improving the health status of humans should be introduced. Research findings in this article show that physical activity with a specific duration and severity can keep a person away from the cardiovascular disease. The result shows that regular physical activity with low intensity and long periods of time is essential for human health. Physical mobility reduces blood pressure, reduces the harmful fats and does not cause cardiovascular disease. More than half of the patients suffering from cardiovascular problems are afflicted with blood lipids. On the other hand, high blood pressure is one of the serious health hazards in the world today, which causes a large number of cardiovascular problems and mortality in the world. Undoubtedly, the second most common risk factor for heart disease is high blood pressure after cigarette smoking.

Keywords: blood pressure, cardiovascular, hyperlipidemia, risk factor

Procedia PDF Downloads 217
4019 Epidemiological Profile of Patients with Painful Degenerative Lumbar Disc Disease

Authors: Ghoul Rachid Brahim

Abstract:

Introduction: Degenerative disc disease is a process of premature and accelerated deterioration of the intervertebral disc; it is of multifactorial origin and is responsible for chronic low back pain. Objectives: Determine an epidemiological profile of patients with painful lumbar degenerative disc disease. Patients and methods: We performed a prospective study of 104 patients operated on for degenerative painful lumbar disc disease over a period of 25 months. The parameters analyzed were: age, sex, Body Mass Index (BMI), comorbidities, family history of low back pain, and difficulty with professional activity. Results: The average age was 43.3 years, with a clear predominance of men: 72 men for 32 women, the average BMI was 26.80Kg / m2, and 63.5% of the patients were overweight. The occurrence of disc degeneration in pathological conditions was noted in 14.4% of cases. The notion of familial low back pain was found in 49% of cases. The majority of patients perform more or less arduous work (51%) in the cases. Conclusion: In our series, degenerative painful lumbar disc disease predominates in the male subject, active obese who performs more or less painful work, in whom we find a family history of low back pain.

Keywords: degenerative disc disease, low back pain, body mass index, disque intervertebrale

Procedia PDF Downloads 73
4018 Broccoli Sprouts Powder Could Improve Metabolic and Liver Disorder-Induced by High-Fructose Corn Syrup

Authors: Zahra Bahadoran, Parvin Mirmiran, Hanieh-Sadat Ejtahed, Maryam Tohidi, Fereidoun Azizi

Abstract:

Background and Aim: Broccoli sprouts, rich source of bioactive compounds specially sulforaphane (SFN), have unique functional properties. This study was conducted to investigate the possible treatment effects of high-SFN broccoli sprouts powder on metabolic and liver disorders in rats fed with high-fructose corn syrup. Methods: Thirty-two male wistar rats, pretreated with an eight-week high-fructose diet (water containing 30% fructose), were randomly allocated into three groups: Baseline control (BC), control (C) (normal diet), and BSP-diet (normal diet+5% BSP). The duration of the study was 6 weeks. Biochemical measurements, liver weight and triglyceride content were evaluated and histopathological examination of liver was performed. Results: After 6-weeks, the liver weight was significantly lower in BSP group compared to controls (13.4 g vs. 11.4 g, P<0.05). After 6 weeks, a significant decrease was observed in fasting serum glucose, total cholesterol and triglyceride levels in both experimental groups (P<0.05). Compared to controls, serum levels of HDL-C were significantly higher in BSP group. The liver TG content in BSP compared to control group was lower (14.6 vs. 16.4 mg/mg tissue). The hepatic levels of alanine aminotransferase, aspartate aminotransferase and γ-glutamyl transferase had not considerable changes in the groups after the intervention period but the level of alkaline phosphatase significantly decreased in BSP group (P<0.05). The histopathological examination of liver confirmed a decrease lobular and portal inflammation and ballooning in BSP group compared to control. Conclusion: High-SFN broccoli sprouts powder has beneficials effect on metabolic and liver changes-induced by high fructose corn syrup.

Keywords: broccoli sprouts, metabolic disorders, fatty liver, food science

Procedia PDF Downloads 390
4017 The Mechanism of Parabacteroides goldsteinii on Immune Modulation and Anti-Obsogenicity

Authors: Yu-Ling Tsai, Chih-Jung Chang, Chia-Chen Lu, Eric Wu, Chuan-Sheng Lin, Tzu-Lung Lin, Hsin-Chih Lai

Abstract:

It is urgent that novel anti-obesity measures that are safe, effective and widely available are developed for counteracting the rapidly growing obesity epidemics. In the present study, we show that a probiotic bacterium Parabacteroides goldsteinii screened through culture under the high molecular weight polysaccharides prepared from two iconic medicinal fungi, the Ganoderma lucidum and the Hirsutella sinensis, reduced body weight by ca. 20% in high-fat diet (HFD)-fed mice. The bacterium also decreased intestinal permeability, metabolic endotoxemia, inflammation and insulin resistance. Notably, oral administration of live, but not high temperature-killed, P. goldsteinii to HFD fed mice considerably reduces weight gain and obesity-associated metabolic disorders. A three months feeding of the mice with P. goldsteinii did not show any aberrant side effects, indicating the safety of this bacterium. Transcriptome analysis indicated that P. goldsteinii enhances immunity in resting dendritic cells, but reduces inflammation in lipopolysaccharide (LPS)-induced dendritic cells. On top, Naïve T-cells were skewed towards regulatory T-cells after encountering with dendritic cells (DCs) pretreated with P. goldsteinii. These results indicated P. goldsteinii showed anti-inflammatory effects and can work as a potential probiotic ameliorating obesogenicity and related metabolic syndromes.

Keywords: Parabacteroides goldsteinii, gut microbiome, obesity, immune modulation

Procedia PDF Downloads 145
4016 Periodontal Disease or Cement Disease: New Frontier in the Treatment of Periodontal Disease in Dogs

Authors: C. Gallottini, W. Di Mari, A. Amaddeo, K. Barbaro, A. Dolci, G. Dolci, L. Gallottini, G. Barraco, S. Eramo

Abstract:

A group of 10 dogs (group A) with Periodontal Disease in the third stage, were subjected to regenerative therapy of periodontal tissues, by use of nano hydroxy apatite (NHA). These animals induced by general anesthesia, where treated by ultrasonic scaling, root planning, and at the end by a mucogingival flap in which it was applied NHA. The flap was closed and sutured with simple steps. Another group of 10 dogs (group B), control group, was treated only by scaling and root planning. No patient was subjected to antibiotic therapy. After three months, a check was made by inspection of the oral cavity, radiography and bone biopsy at the alveolar level. Group A showed a total restitutio ad integrum of the periodontal structures, and in group B still mild gingivitis in 70% of cases and 30% of the state remains unchanged. Numerous experimental studies both in animals and humans have documented that the grafts of porous hydroxyapatite are rapidly invaded by fibrovascular tissue which is subsequently converted into mature lamellar bone tissue by activating osteoblast. Since we acted on the removal of necrotic cementum and rehabilitating the root tissue by polishing without intervention in the ligament but only on anatomical functional interface of cement-blasts, we can connect the positive evolution of the clinical-only component of the cement that could represent this perspective, the only reason that Periodontal Disease become a Cement Disease, while all other clinical elements as nothing more than a clinical pathological accompanying.

Keywords: nanoidroxiaphatite, parodontal disease, cement disease, regenerative therapy

Procedia PDF Downloads 419
4015 Links between Inflammation and Insulin Resistance in Children with Morbid Obesity and Metabolic Syndrome

Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Obesity is a clinical state associated with low-grade inflammation. It is also a major risk factor for insulin resistance (IR). In its advanced stages, metabolic syndrome (MetS), a much more complicated disease which may lead to life-threatening problems, may develop. Obesity-mediated IR seems to correlate with the inflammation. Human studies performed particularly on pediatric population are scarce. The aim of this study is to detect possible associations between inflammation and IR in terms of some related ratios. 549 children were grouped according to their age- and sex-based body mass index (BMI) percentile tables of WHO. MetS components were determined. Informed consent and approval from the Ethics Committee for Clinical Investigations were obtained. The principles of the Declaration of Helsinki were followed. The exclusion criteria were infection, inflammation, chronic diseases and those under drug treatment. Anthropometric measurements were obtained. Complete blood cell, fasting blood glucose, insulin, and C-reactive protein (CRP) analyses were performed. Homeostasis model assessment of insulin resistance (HOMA-IR), systemic immune inflammation (SII) index, tense index, alanine aminotransferase to aspartate aminotransferase ratio (ALT/AST), neutrophils to lymphocyte (NLR), platelet to lymphocyte, and lymphocyte to monocyte ratios were calculated. Data were evaluated by statistical analyses. The degree for statistical significance was 0.05. Statistically significant differences were found among the BMI values of the groups (p < 0.001). Strong correlations were detected between the BMI and waist circumference (WC) values in all groups. Tense index values were also correlated with both BMI and WC values in all groups except overweight (OW) children. SII index values of children with normal BMI were significantly different from the values obtained in OW, obese, morbid obese and MetS groups. Among all the other lymphocyte ratios, NLR exhibited a similar profile. Both HOMA-IR and ALT/AST values displayed an increasing profile from N towards MetS3 group. BMI and WC values were correlated with HOMA-IR and ALT/AST. Both in morbid obese and MetS groups, significant correlations between CRP versus SII index as well as HOMA-IR versus ALT/AST were found. ALT/AST and HOMA-IR values were correlated with NLR in morbid obese group and with SII index in MetS group, (p < 0.05), respectively. In conclusion, these findings showed that some parameters may exhibit informative differences between the early and late stages of obesity. Important associations among HOMA-IR, ALT/AST, NLR and SII index have come to light in the morbid obese and MetS groups. This study introduced the SII index and NLR as important inflammatory markers for the discrimination of normal and obese children. Interesting links were observed between inflammation and IR in morbid obese children and those with MetS, both being late stages of obesity.

Keywords: children, inflammation, insulin resistance, metabolic syndrome, obesity

Procedia PDF Downloads 102
4014 Environmental Metabolic Rift and Tourism Development: A Look at the Impact of the Malawi Tourism Industry Development Pattern

Authors: Lameck Zetu Khonje, Mulala Danny Simatele

Abstract:

The tourism industry in Malawi has grown tremendously during the past twenty-five years. This growth is attributed to the change in the political system which opened doors to international tourist and investment opportunities in the country which previously was under a strict repressive one-party political system. This research paper focuses on the developments that took place in the accommodation sector during the same period and the impact that it has partly caused on an environmental metabolic rift in the country which is now vulnerable to climate change-related catastrophes. Respondents from the government departments and the hotel sector were recruited for in-depth interviews. These interviews were conducted between July and November 2015 and follow up interviews were conducted between September and December 2017. Both results indicated there were minimal efforts pursued from the public sector to cartel capitalistic development tendencies in the accommodation sector. The results from the hotel revealed there were considerable efforts pursued driven by operating cost-cutting motive. Applying systems thinking the paper recommends that the policing machinery needs improvement to ensure that the industry also focuses on environmental wellbeing instead of profit maximization. This paper contributes to the body of knowledge on tourism development and climate change.

Keywords: accommodation sector, climate change, metabolic rift, Malawi, tourism industry

Procedia PDF Downloads 110
4013 Prevalence of Lupus Glomerulonephritis in Renal Biopsies in an Eastern Region of the Arab World

Authors: M. Fayez Al Homsi, Reem Al Homsi

Abstract:

Renal disease is a major cause of morbidity and mortality. Glomerular diseases make a small portion of the renal disease. Lupus glomerulonephritis (GN) is the commonest among the GN of systemic diseases. More than a hundred and eighty-eight consecutive renal biopsies are performed and evaluated for clinically suspected glomerular diseases over a period of two years. As in a standard practice after receiving the ultrasound-guided renal biopsies, the fresh biopsy is divided to three parts, one part is frozen for immunofluorescence evaluation, the second part is placed in 4% glutaraldehyde for electron microscopic evaluation, and the third part is placed in 10% buffered formalin for light microscopic evaluation. Primary glomerular diseases are detected in 83 biopsies; glomerulonephritis (GN) of systemic diseases are identified in 88, glomerular lesions in vascular diseases in 3, glomerular lesions in metabolic diseases in 7, hereditary nephropathies in 2, end-stage kidney in 2, and glomerular lesions in transplantation in 3 biopsies. Among the primary lesions, focal segmental glomerulosclerosis (28) and mesangial proliferative GN (26) were the most common. Lupus GN (67) and Ig A nephropathy (20) were the most common of the GN of systemic diseases. Lupus nephritis biopsies included one biopsy diagnosed as class 1 (normal), 17 biopsies class 2 (mesangial proliferation), 5 biopsies class 3 (focal proliferative GN), 39 biopsies class 4 diffuse proliferative GN), 3 biopsies class 5 (membranous GN), and 2 biopsies class 6 (crescentic GN). Lupus GN is the most common among GN of systemic diseases. While diabetes is very common here, diabetic GN (3 biopsies) is not as common as might one expects. Most likely this is due to sampling and reluctance on part of nephrologists and patients in sampling the kidney in diabetes mellitus.

Keywords: diabetes, glomerulonephritis, lupus, mesangial proliferation, nephropathy

Procedia PDF Downloads 108
4012 Immunoglobulins and Importance in Ruminants

Authors: M. Akoz, O. B. Citil, I. Aydin

Abstract:

Colostrum secreted by the mammary glands after birth in the early days, a high proportion of fat, protein and ash containing a secretion containing low amounts of casein and lactose. Especially immunoglobulins contain high proportions. Maternal immunoglobulins own immune system to protect the newborn against neonatal disease until development are very important matter. However, colostrum is transferred to the offspring due to placental barrier in ruminants. Immunoglobulins are absorbed through the intestinal epithelium but absorption can vary under the influence of some factors. These factors are among the priority ones taking colostrum first time, amount, concentration, the metabolic status of the newborn. intestinal absorption of immunoglobulins occurs over the first 24 h high. Absorption from the gut after nine hours, 50% after 24 hours was only 11%. On the other hand pup's digestive system degrade the enzymes after 24 hours immunoglobulins. Bovine colostrum in the composition while basic immune IgG, IgA and IgM are also available. Total IgG in colostrum of ruminants, while in other species is a greater amount in blood serum.

Keywords: immunoglobulin, ruminants, colostrum, immune system

Procedia PDF Downloads 249
4011 Defining of the Shape of the Spine Using Moiré Method in Case of Patients with Scheuermann Disease

Authors: Petra Balla, Gabor Manhertz, Akos Antal

Abstract:

Nowadays spinal deformities are very frequent problems among teenagers. Scheuermann disease is a one dimensional deformity of the spine, but it has prevalence over 11% of the children. A traditional technology, the moiré method was used by us for screening and diagnosing this type of spinal deformity. A LabVIEW program has been developed to evaluate the moiré pictures of patients with Scheuermann disease. Two different solutions were tested in this computer program, the extreme and the inflexion point calculation methods. Effects using these methods were compared and according to the results both solutions seemed to be appropriate. Statistical results showed better efficiency in case of the extreme search method where the average difference was only 6,09⁰.

Keywords: spinal deformity, picture evaluation, Moiré method, Scheuermann disease, curve detection, Moiré topography

Procedia PDF Downloads 333
4010 Maackiain Attenuates Alpha-Synuclein Accumulation and Improves 6-OHDA-Induced Dopaminergic Neuron Degeneration in Parkinson's Disease Animal Model

Authors: Shao-Hsuan Chien, Ju-Hui Fu

Abstract:

Parkinson’s disease (PD) is a degenerative disorder of the central nervous system that is characterized by progressive loss of dopaminergic neurons in the substantia nigra pars compacta and motor impairment. Aggregation of α-synuclein in neuronal cells plays a key role in this disease. At present, therapeutics for PD provides moderate symptomatic benefit but is not able to delay the development of this disease. Current efforts for the treatment of PD are to identify new drugs that show slow or arrest progressive course of PD by interfering with a disease-specific pathogenetic process in PD patients. Maackiain is a bioactive compound isolated from the roots of the Chinese herb Sophora flavescens. The purpose of the present study was to assess the potential for maackiain to ameliorate PD in Caenorhabditis elegans models. Our data reveal that maackiain prevents α-synuclein accumulation in the transgenic Caenorhabditis elegans model and also improves dopaminergic neuron degeneration, food-sensing behavior, and life-span in 6-hydroxydopamine-induced Caenorhabditis elegans model, thus indicating its potential as a candidate antiparkinsonian drug.

Keywords: maackiain, Parkinson’s disease, dopaminergic neurons, α-Synuclein

Procedia PDF Downloads 168
4009 Comprehensive Profiling and Characterization of Untargeted Extracellular Metabolites in Fermentation Processes: Insights and Advances in Analysis and Identification

Authors: Marianna Ciaccia, Gennaro Agrimi, Isabella Pisano, Maurizio Bettiga, Silvia Rapacioli, Giulia Mensa, Monica Marzagalli

Abstract:

Objective: Untargeted metabolomic analysis of extracellular metabolites is a powerful approach that focuses on comprehensively profiling in the extracellular space. In this study, we applied extracellular metabolomic analysis to investigate the metabolism of two probiotic microorganisms with health benefits that extend far beyond the digestive tract and the immune system. Methods: Analytical techniques employed in extracellular metabolomic analysis encompass various technologies, including mass spectrometry (MS), which enables the identification of metabolites present in the fermentation media, as well as the comparison of metabolic profiles under different experimental conditions. Multivariate statistical analysis techniques like principal component analysis (PCA) or partial least squares-discriminant analysis (PLS-DA) play a crucial role in uncovering metabolic signatures and understanding the dynamics of metabolic networks. Results: Different types of supernatants from fermentation processes, such as dairy-free, not dairy-free media and media with no cells or pasteurized, were subjected to metabolite profiling, which contained a complex mixture of metabolites, including substrates, intermediates, and end-products. This profiling provided insights into the metabolic activity of the microorganisms. The integration of advanced software tools has facilitated the identification and characterization of metabolites in different fermentation conditions and microorganism strains. Conclusions: In conclusion, untargeted extracellular metabolomic analysis, combined with software tools, allowed the study of the metabolites consumed and produced during the fermentation processes of probiotic microorganisms. Ongoing advancements in data analysis methods will further enhance the application of extracellular metabolomic analysis in fermentation research, leading to improved bioproduction and the advancement of sustainable manufacturing processes.

Keywords: biotechnology, metabolomics, lactic bacteria, probiotics, postbiotics

Procedia PDF Downloads 39
4008 Micro/Nano-Sized Emulsions Exhibit Antifungal Activity against Cucumber Downy Mildew

Authors: Kai-Fen Tu, Jenn-Wen Huang, Yao-Tung Lin

Abstract:

Cucumber is a major economic crop in the world. The global production of cucumber in 2017 was more than 71 million tonnes. Nonetheless, downy mildew, caused by Pseudoperonospora cubensis, is a devastating and common disease on cucumber in around 80 countries and causes severe economic losses. The long-term usage of fungicide also leads to the occurrence of fungicide resistance and decreases host resistance. In this study, six types of oil (neem oil, moringa oil, soybean oil, cinnamon oil, clove oil, and camellia oil) were selected to synthesize micro/nano-sized emulsions, and the disease control efficacy of micro/nano-sized emulsions were evaluated. Moreover, oil concentrations (0.125% - 1%) and droplet size of emulsion were studied. Results showed cinnamon-type emulsion had the best efficacy among these oils. The disease control efficacy of these emulsions increased as the oil concentration increased. Both disease incidence and disease severity were measured by detached leaf and pot experiment, respectively. For the droplet size effect, results showed that the 114 nm of droplet size synthesized by 0.25% cinnamon oil emulsion had the lowest disease incidence (6.67%) and lowest disease severity (33.33%). The release of zoospore was inhibited (5.33%), and the sporangia germination was damaged. These results suggest that cinnamon oil emulsion will be a valuable and environmentally friendly alternative to control cucumber downy mildew. The economic loss caused by plant disease could also be reduced.

Keywords: downy mildew, emulsion, oil droplet size, plant protectant

Procedia PDF Downloads 100
4007 CMT4G: Rare Form of Charcot-Marie-Tooth Disease in Slovak Roma Patient

Authors: Dana Gabriková, Martin Mistrík, Jarmila Bernasovská, Iveta Tóthová, Jana Kisková

Abstract:

The Roma (Gypsies) is a transnational minority with a high degree of consanguineous marriages. Similar to other genetically isolated founder populations, the Roma harbor a number of unique or rare genetic disorders. This paper discusses about a rare form of Charcot-Marie-Tooth disease – type 4G (CMT4G), also called Hereditary Motor and Sensory Neuropathy type Russe, an autosomal recessive disease caused by mutation private to Roma characterized by abnormally increased density of non-myelinated axons. CMT4G was originally found in Bulgarian Roma and in 2009 two putative causative mutations in the HK1 gene were identified. Since then, several cases were reported in Roma families mainly from Bulgaria and Spain. Here we present a Slovak Roma family in which CMT4G was diagnosed on the basis of clinical examination and genetic testing. This case is a further proof of the role of the HK1 gene in pathogenesis of the disease. It confirms that mutation in the HK1 gene is a common cause of autosomal recessive CMT disease in Roma and should be considered as a common part of a diagnostic procedure.

Keywords: gypsies, HK1, HSMN-Russe, rare disease

Procedia PDF Downloads 362
4006 Validity of Clinical Disease Activity Index (CDAI) to Evaluate the Disease Activity of Rheumatoid Arthritis Patients in Sri Lanka: A Prospective Follow up Study Based on Newly Diagnosed Patients

Authors: Keerthie Dissanayake, Chandrika Jayasinghe, Priyani Wanigasekara, Jayampathy Dissanayake, Ajith Sominanda

Abstract:

The routine use of Disease Activity Score-28 (DAS28) to assess the disease activity in rheumatoid arthritis (RA) is limited due to its dependency on laboratory investigations and the complex calculations involved. In contrast, the clinical disease activity index (CDAI) is simple to calculate, which makes the "treat to target" strategy for the management of RA more practical. We aimed to assess the validity of CDAI compared to DAS28 in RA patients in Sri Lanka. A total of 103 newly diagnosed RA patients were recruited, and their disease activity was calculated using DAS 28 and CDAI during the first visit to the clinic (0 months) and re-assessed at 4 and 9 months of the follow-up visits. The validity of the CDAI, compared to DAS 28, was evaluated. Patients had a female preponderance (6:1) and a short symptom duration (mean = 6.33 months). The construct validity of CDAI, as assessed by Cronbach's α test, was 0.868. Convergent validity was assessed by correlation and Kappa statistics. Strong positive correlations were observed between CDAI and DAS 28 at the baseline (0 months), 4, and 9 months of evaluation (Spearman's r = 0.9357, 0.9354, 0.9106, respectively). Moderate-good inter-rater agreements between the DAS-28 and CDAI were observed (Weighted kappa of 0.660, 0.519, and 0.741 at 0, 4, and 9 months respectively). Discriminant validity, as assessed by ROC curves at 0, 4th, and 9th months of the evaluation, showed the area under the curve (AUC) of 0.958, 0.985, and 0.914, respectively. The suggested cut-off points for different CDAI disease activity categories according to ROC curves were ≤ 2 (Remission), >2 to ≤ 5 (low), >5 to ≤ 18 (moderate), > 18 (high). These findings indicate that the CDAI has good concordance with DAS 28 in assessing the disease activity in RA patients in this study sample.

Keywords: rheumatoid arthritis, CDAI, disease activity, Sri Lanka, validation

Procedia PDF Downloads 121