Predictores del estado de salud funcional posingreso en cuidados intensivos en pacientes sépticos / Predictors of Post-Admission Functional Health Status in Intensive Care in Septic Patients

Introducción: Los pacientes críticos pediátricos son susceptibles de presentar alteraciones del flujo sanguíneo cerebral que impliquen un deterioro de su estado de salud funcional. Objetivo: Identificar factores predictores de mayor riesgo de mala evolución funcional en pacientes pediátricos críticos con sepsis. Métodos: Se realizó un estudio de cohortes retrospectivo con menores de 18 años de edad con sepsis, ingresados en la unidad de cuidados intensivos pediátricos. Se recogieron variables epidemiológicas, clínicas y del estado de salud funcional previas al ingreso, al alta y a los 6 meses. El estado de salud funcional se evaluó mediante la escala de categorías de estado global y cerebral pediátrico. Se evaluó el cambio del estado funcional entre el ingreso y a los 6 meses del alta. Se realizó un análisis univariante para comparar grupos considerando el mal pronóstico y el cambio del estado funcional y su relación con las variables. Resultados: Se incluyeron 46 pacientes. A los 6 meses del alta, cuatro (8,7 por ciento) presentaron mal pronóstico funcional y ocho (17,4 por ciento) empeoramiento funcional respecto al ingreso. No se encontraron asociaciones entre las variables predictoras y la morbilidad, aunque se observó cierta tendencia en algunas como mayor soporte inotrópico (VIS > 20: 12,5 por ciento vs. 50 por ciento, p= 0,075), extracorpóreo y de reemplazo renal (25 por ciento vs. 2,6 por ciento, p= 0,074) y estancia hospitalaria más prolongada (50 por ciento vs. 15,8 por ciento , p= 0,055). Conclusiones: El soporte en la unidad de cuidados intensivos pediátricos no fue un predictor de morbilidad funcional en la muestra(AU)

Introduction: Critically ill pediatric patients are susceptible to cerebral blood flow alterations that imply a deterioration of their functional health status. Objective: To identify predictors of a higher risk of poor functional outcome in critically ill pediatric patients with sepsis. Methods: A retrospective cohort study was conducted with children under 18 years of age with sepsis, who were admitted to the pediatric intensive care unit. Epidemiological, clinical, and functional health status variables were collected prior to admission, discharge, and after 6 months. Functional health status was assessed using the Pediatric Global State and Brain Status Category Scale. The change in performance status between admission and 6 months after discharge was assessed. A univariate analysis was performed to compare groups considering poor prognosis and change in functional status and their relationship with the variables. Results: A total of 46 patients were included. At 6 months after discharge, four (8.7 percent) had a poor functional prognosis and eight (17.4 percent) had functional worsening at admission. No associations were found between the predictor variables and morbidity, although some trends were observed in some variables, such as greater inotropic support (SIV > 20: 12.5 percent vs. 50 percent, p = 0.075), extracorporeal and renal replacement (25 percent vs. 2.6 , percent p = 0.074), and longer hospital stay (50 percent vs. 15.8 percent , p = 0.055). Conclusions: Support in the pediatric intensive care unit was not a predictor of functional morbidity in the sample(AU)

Correlation between iodine nutrition and thyroid function of pregnant women in Xinjiang Uygur Autonomous Region / 中华地方病学杂志

Objective:Through the detection of iodine nutrition level and thyroid function of pregnant women in Xinjiang Uygur Autonomous Region (Xinjiang), to preliminary study the pregnant women's iodine nutrition level, thyroid function status and the relationship between the two and influencing factors.Methods:From March to June in 2020, stratified cluster random sampling method was adopted. Two counties (cities) in Southern and Northern Xinjiang were selected as survey sites, and about 100 pregnant women (a total of 412) were selected from each county (city) as survey subjects. Random urine samples and blood samples were collected to detect urinary iodine and serum thyroid function indicators [thyroid stimulating hormone (TSH), free triiodothyronine (FT 3), free thyroxine (FT 4), anti-thyroglobulin antibody (Tg-Ab) and anti-thyroid peroxidase antibody (TPO-Ab)]. Results:The median and interquartile range [ M ( Q1, Q3)] of pregnant women's urinary iodine was 228.4 (143.15, 327.95) μg/L. Serum FT 3, FT 4 and TSH levels [ M ( Q1, Q3)] were 4.22 (3.92, 4.61), 13.79 (12.63, 15.26) pmol/L and 1.82 (1.26, 2.52) mU/L, respectively. The overall positive rates of Tg-Ab and TPO-Ab were 5.61% (23/412) and 11.95% (49/412), respectively. The positive rates of Tg-Ab and TPO-Ab in Southern and Northern Xinjiang were 4.78% (10/209), 10.05% (21/209), 6.40% (13/203) and 13.79% (28/203), respectively. The positive rates of Tg-Ab and TPO-Ab in Northern Xinjiang were higher than those in Southern Xinjiang, but the difference was not statistically significant (χ 2 = 1.31, 2.17, P > 0.05). The positive rate of TPO-Ab in pregnant women was the influencing factor of abnormal thyroid function, and the odds ratio ( OR) [95% confidence interval ( CI)] was 3.22 (1.31 - 7.93). Conclusions:Pregnant women in Xinjiang are generally at an appropriate level of iodine, but the state of thyroid function still needs continuous attention. In addition, it is necessary to strengthen the thyroid function examination of pregnant women with positive thyroid autoantibodies to prevent and control the occurrence of abnormal thyroid function in pregnant women.

Observational Study on Thyroid Function Status in Patients attending a Tertiary Care Hospital

Thyroid disorders constitute the commonest endocrine abnormality. 42 million people in India are suffering from thyroid disorders. Methods: The present hospital-based study was conducted upon 136 patients reporting to OPD of VIMS, Pawapuri to evaluate their thyroid function status. Detailed history was taken along with blood sample collection after overnight fast for estimation of thyroid hormones. Results: Majority of the patients belonged to the age group of 20-40 years (47.8%). Male: female ratio was 3.69. 71.3% of the patients were euthyroid. 19.8% patients were hypothyroid of which 13.2% were clinically euthyroid, 3.7% suffered from subclinical hypothyroidism and 2.9% had primary hypothyroidism. 9.4% were hyperthyroid of which 5.1% had central hyperthyroidism, 2.9% suffered from primary hyperthyroidism, and 0.7% each had subclinical hyperthyroidism and T3 thyrotoxicosis. Conclusion: Hypothyroidism is alarmingly high in this region with higher prevalence in women.

Pulmonary Function Impairment in Female Workers Exposed to Environments with Varied Ambient Air Pollution in the Central Business Area of Lusaka-Zambia.

Aims: To determine the lung function of cleaners exposed to particulate matter of aerodynamic diameter less than 2.5 micrometer (PM2.5) in the streets and offices in Lusaka, Zambia. Study Design: This was a cross sectional study between two groups. Place and Duration of Study: Lusaka city, central business area, between June and August 2014. Methodology: The study included women between 18-50 years of age who had been working as street or office cleaners for 6 months or more. Males and individuals in both groups who used to smoke or were currently smokers, as well as those with a history of respiratory related illnesses or had cardiopulmonary conditions were excluded from the study. The cleaners were interviewed to get information on socio-demographic characteristics and other information using a structured interview schedule. The participants’ lung volumes, forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and their ratio (FEV1/FVC) were measured using a MRI spirobank G spirometer. On the day of the interview, PM2.5 in their work environment was sampled using a personal aerosol monitor (SIDEPAK AM510). Results: Out of the 90 participants, 45 were street sweepers and 45 were office cleaners. More street sweepers had impaired lung function (FEV1/FVC) 15(75%) than office cleaners 5(25%) p=0.01. FEV1 was also significantly different among street sweepers 12(70.6%) and office cleaners 5(29.4%) p=0.05. PM2.5 measurements revealed significantly high levels of exposure among street sweepers (p=0.001). Participants with impaired lung function (p=.005) and those with reduced FEV1percent predicted were exposed to significantly high concentrations of PM2.5 (p=0.012). Conclusion: Exposure to high PM2.5 concentration is associated with pulmonary function impairment and reduced FEV1 % predicted among cleaners.

Assessment of Some Aspects of Cardiovascular Function Status in Male Patients with Stable COPD.

Background: COPD is a preventable and treatable disease with some important extra pulmonary effects, which may contribute to the severity of this disease. Among these extra pulmonary ailments cardiovascular disorders are noteworthy. Although its silent involvement is known, but little attention paid to this major comorbidity while treating COPD patients. Objective: to assess rate, systolic blood pressure (SBP) and peak systolic velocity (PSV) of blood flow to observe the cardiovascular function status in stable COPD patients Methods: This cross-sectional study was carried out in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka during 2010. For this purpose 60 (sixty) male, smoker (5 to 10 pack years) patients of stable COPD (FEV1/FVC% <0.70; FEV1 e” 80%; without any exacerbation for last 4 weeks) were randomly selected from the Out Patient Department of the Department of Cardiology, BSMMU and also from a private clinic in Dhaka city. On the basis of spirometric findings, 30 mild (group B1) and 30 moderate stage (group B2) of COPD patients with age 35-45 years were included in the study. In addition, 30 age and BMI matched apparently healthy male persons were studied as control (group A). For assessment of cardiovascular function, pulse rate, SBP and PSV were measured. PSV of blood flow in distal part of the right brachial artery in arm was measured by Color Doppler ultrasonography. For statistical analysis, Independent sample t-test and Pearson’s Correlation Coefficient test were used. Results: Significantly (p<0.001) higher mean pulse rate and SBP were observed in moderate stage of COPD patients than those of control and mild stage. PSV was significantly (p<0.001) higher in both stages than those of the control as well as in moderate stage to that of the mild COPD. In addition, SBP and PSV were negatively correlated with FEV1 in moderate stage which was statistically significant (p<0.01). Conclusion: This study suggests that, cardiovascular status may be altered in stable COPD and this alteration is inversely related to the severity of the disease.

A Scoring Method for Quantitative Assessment of Cardiovascular Health Status Based on Non-linear Parameters / 航天医学与医学工程

Objective To study a scoring method for assessing function status of cardiovascular system quantitatively. Methods First, exercise heart rate variability (EHRV) was obtained from the primary dynamic electrocardiogram (ECG) recorded during exercise testing. Then appropriate entropy, relative complexity, and other three parameters extracted from poincare dispersed-dot plot were extracted from the EHRV. Discriminant analysis was used to classify two extreme groups.Results Based on the values of two groups from the discriminant formula, a scoring formula was proposed and four ranks were divided according to different score domains. A novel scoring method was established. To validate the proposed scoring method, 60 middle-aged hypertensives, 50 elder subjects and 110 young healthy subjects were examined and scored. Conclusion Scores of 220 subjects are consistent with their real health status. The proposed scoring method reflects the status of the subject's cardiovascular system effectively.

Clinical Course and Predictable Factors for Remission of Hashimoto' Thyroiditis in Children and Adolescents / 대한소아내분비학회지

PURPOSE:The natural course of Hashimoto' thyroiditis (HT) is so dynamic that the disease progresses to overt hypothyroid or spontaneous recovery. The authors reviewed the clinical course of this disease and analysed the possible predicting factors regarding remission. METHODS:Thirty nine patients with HT (38 girls and 1 boy) were studied retrospectively. Of these patients, 30 were followed for more than 2 years. The possible remission factors were analyzed at initial diagnosis and during follow-up period. RESULTS:The mean age at the diagnosis was 11.8+/-.1 years. Initial thyroid function was euthyroid in 38.5%, compensated hypothyroid in 35.9%, overt hypothyroid in 23.1%, and hyperthyroid in 2.6% of patients. Antithyroglobulin antibody (ATA) was positive in 94.7%, and antimicrosomal antibody (AMA) was positive in 74.4%. The overall remission rate was 53.3% during the follow-up period (51+/-7 months). Initial goiter size, thyroid function status, and autoantibody titer had no relation to the remission rate statistically. Follow-up autoantibody titers in remission group were marginally lower than those in nonremission group (P<0.1), and follow-up AMA titer was significantly higher than initial titers in nonremission group (P<0.05). CONCLUSION: We could not find any predictable remission factors from the initial clinical and autoantibody status. But, during follow-up period, patients with lower autoantibody titers showed slight higher remission, and those with increasing AMA titer showed less remission. Above results suggest that we should monitor antithyroid antibody titer as well as thyroid function regularly.