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Background: Childhood obesity has become a global concern, with its prevalence steadily increasing over the past decade. This condition negatively impacts the cardiovascular system, increasing the risk of morbidity and mortality in adulthood. This study aimed to identify cardiac function abnormalities and related risk factors among overweight and obese Thai children. Materials and Methods: A cross sectional observational study of 70 children with body mass index (BMI) >1 standard deviation above the mean for Thai children was conducted at Naresuan University Hospital. Body fat percentage (%Fat) was measured, and standard transthoracic echocardiography was performed. Metabolic profiles were collected from medical records. Results: The thickness and diameter of the Left ventricle (LV) wall, including the LV posterior wall, LV internal diameter, and interventricular septum (IVS), were significantly increased in both systolic and diastolic phases in obese children. LV concentric hypertrophy and an abnormal E/E' ratio were found in 27% and 34.3% of participants, respectively. Right ventricular systolic dysfunction indicated by abnormal tricuspid annular plane systolic excursion values was found in 55.7% of all participants. In addition, 27.1% of all obese children had pulmonary hypertension. Significant differences in BMI and %Fat were detected between children with abnormal and normal IVS diastolic (IVSd) (P = 0.016). Our univariate and multivariate correlation analyses revealed a significant positive association between abnormal IVSd and %Fat, with an odd ratio (OR) of 1.13 (95% confidence interval [CI]: 1.01-1.27; P = 0.047) and an adjusted OR of 1.17 (95% CI: 1.01-1.36; P = 0.04). Conclusions: Cardiac function abnormalities in childhood obesity exhibit a significant positive correlation with BMI and various cardiac dimensions, including ventricular wall thickness. One important related risk factor for increased IVS thickness is %Fat. Therefore, multidisciplinary management of obesity should be initiated as early as possible to prevent future cardiovascular morbidity and mortality. [ABSTRACT FROM AUTHOR]

Background: Inadvertent perioperative hypothermia is an unintentional drop in core body temperature to less than 36 °C perioperatively and is associated with many negative outcomes such as infection, a prolonged stay in a recovery room, and decreased patient comfort. Objective: To determine the incidence of postoperative hypothermia and to identify the associated factors with postoperative hypothermia in patients undergoing head, neck, breast, general, urology, and vascular surgery. The incidences of pre- and intraoperative hypothermia were examined as the intermediate outcomes. Materials and methods: A retrospective chart review was conducted in adult patients undergoing surgery at a university hospital in a developing country for two months (October to November 2019). Temperatures below 36 °C were defined as hypothermia. Univariate and multivariate analyses were used to identify factors associated with postoperative hypothermia. Results: A total of 742 patients were analyzed, the incidence of postoperative hypothermia was 11.9% (95% CI 9.7%-14.3%), and preoperative hypothermia was 0.4% (95% CI 0.08%-1.2%). Of the 117 patients with intraoperative core temperature monitoring, the incidence of intraoperative hypothermia was 73.5% (95% CI 58.8–90.8%), and hypothermia occurred most commonly after anesthesia induction. Associated factors of postoperative hypothermia were ASA physical status III-IV (OR = 1.78, 95%CI 1.08–2.93, p = 0.023) and preoperative hypothermia (OR = 17.99, 95%CI = 1.57-206.89, p = 0.020). Patients with postoperative hypothermia had a significantly longer stay in the PACU (100 min vs. 90 min, p = 0.047) and a lower temperature when discharged from PACU (36.2 °C vs. 36.5 °C, p < 0.001) than those without hypothermia. Conclusion: This study confirms that perioperative hypothermia remains a common problem, especially in the intraoperative and postoperative periods. High ASA physical status and preoperative hypothermia were associated factors of postoperative hypothermia. In order to minimize the incidence of perioperative hypothermia and enhance patient outcomes, appropriate temperature management should be emphasized in patients at high risk. Registration: Clinical Trials.gov (NCT04307095) (13/03/2020). [ABSTRACT FROM AUTHOR]

Background: The body of evidence on surgical intensive care unit (SICU) mortality and its predictors is still being determined. This study analyzed the significant predicting factors for mortality in SICU patients. Materials and Methods: The medical records of patients in SICUs at Her Royal Highness Princess Maha Chakri Sirindhorn Medical Center, Srinakharinwirot University, from June 2020 to July 2021, were retrospectively reviewed. Patients were excluded if transferred from other hospitals and not undergoing orthopedics, otolaryngology, obstetrics, and gynecology surgeries. Results: A total of 276 patients admitted to SICUs were included in this analysis, and 60.5% were men. The mean age was 60.07 ± 17.19 years. The average length of SICU stay was 8.1 ± 10.79 days, and the mortality rate was 23.6%. By univariate analysis, significant predictive factors for mortality rate in SICU patients were acute physiology and chronic health evaluation II (APACHE II) (p < 0.001), Glasgow coma scale (GCS) = 8 (p < 0.001), sequential organ failure assessment (SOFA) score (p < 0.001), serum albumin < 2.5 (p = 0.013), and sepsis or septic shock (p < 0.001). From receiver operating characteristics (ROC) curve analysis to predict mortality, the best cut-off point of APACHE II and SOFA scores were 15.5 and 5.5, respectively. The multivariate logistic regression analysis significantly identified APACHE II > 15, GCS = 8 and SOFA score > 5 as significant predictive factors associated with the mortality rate in SICU patients. Conclusions: APACHE II > 15, GCS = 8, and SOFA score > 5 are predictive mortality factors in SICU patients. Patients with these factors should be given priority for admission to the SICU when there is a discrepancy between the demand and the supply for SICU beds. [ABSTRACT FROM AUTHOR]

The use of a mobile application could be a valuable resource for providing ongoing self-management education and support for people with diabetes. This study is the first in Thailand to assess the efficacy of insulin injection education via mobile messenger applications in adults with type 2 diabetes. An open-label, randomized, three-armed study was conducted. Group 1 (n = 27) received an individual insulin injection education session from a diabetic educator. Group 2 (n = 26) received an initial insulin injection education session in the same manner as group 1, then messages regarding insulin injection knowledge were sent via messenger application twice a week for 3 months consecutively. Group control (n = 27) received only routine care. The primary endpoint was the difference in hemoglobin A1c from baseline to month 6 after the intervention. Outcomes included changes in fasting plasma glucose, and knowledge scores on insulin injection were also evaluated. Results indicated that participants in both group 2 and group 1 showed a significant reduction in hemoglobin A1c at 6 months compared to controls. However, hemoglobin A1c reduction between groups 2 and group 1 showed no statistical significance. In terms of scores on knowledge of insulin injection, results indicated that the increase in scores on knowledge at 6 months in group 2 was greater than both the control and group 1. This finding demonstrated that insulin injection education is important to improve glycemic control in insulin-treated type 2 diabetes, regardless of delivery methods. Despite no significant difference compared to the education session in terms of glycemic control, a mobile messenger education should be considered as one of the effective interventions in improving knowledge scores on insulin injection. Also, nurses can facilitate ongoing coaching by using smartphones and mobile communication applications, which are easy to use and follow-up in diabetes education. [ABSTRACT FROM AUTHOR]

Background: To determine the impact of dental status, types, and quality of dental prostheses on body composition, masticatory performance and oral health-related quality of life (OHRQoL). Potential associations between body composition, masticatory performance and OHRQoL were also investigated. Methods: This cross-sectional study included 110 older adults who received prosthodontic treatment at the Dental Faculty Clinics at Chulalongkorn University. Participants were categorized according to their dental prostheses: complete denture (CD), removable partial denture (RPD) and fixed partial denture (FPD). Retention and stability of the RPD and CD were evaluated using the CU-modified Kapur and the modified NHANES III criteria to classify denture quality into acceptable and unacceptable. Dental status including posterior occluding pairs and number of remaining natural teeth were assessed intraorally. Dependent variables were body composition, masticatory performance and OHRQoL. Body composition, including muscle mass (kg), bone mass (kg), basal metabolic rate (kcal) and visceral fat (%) were determined through a bioelectrical impedance analysis. Masticatory performance was assessed using a multiple sieve method of peanut mastication. OHRQoL was assessed using the validated Thai version of Oral Impacts on Daily Performances (Thai-OIDP) index. After adjusting for covariates, including age and sex, the associations between oral and dental prosthesis status and body composition, masticatory performance as well as OIDP score were analyzed using multivariable linear and negative binomial regression analyses. Spearman's correlation was used to determine the potential associations between body composition, masticatory performance and OHRQoL. Results: The presence of fewer natural teeth or wearing an unacceptable removable denture were factors associated with lower bone mass, muscle mass and basal metabolic rate, and with a higher visceral fat. Similar dental and removable denture status were also associated with larger peanut particle size and higher OIDP score. Masticatory performance and OHRQoL variables were moderately correlated (Spearman's rho = 0.44). However, body composition was not correlated with masticatory performance or OHRQoL. Conclusions: In individuals wearing dental prostheses, factors such as severity of tooth loss, types, and quality of dental prostheses, particularly retention and stability, negatively impacted not only masticatory function and OHRQoL, but also their overall body composition and health. [ABSTRACT FROM AUTHOR]