11 results on '"Medical parameters"'
Search Results
2. AN APPLICATION FOR MONITORING AND DIAGNOSIS THE HEALTH OF A HUMAN SUBJECT
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Madalina Carbureanu and Petrus Bratu
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monitoring ,diagnosis ,neuro-fuzzy inference systems ,fuzzy rules ,medical parameters ,Technology (General) ,T1-995 ,Science - Abstract
The paper presents an application developed for monitoring the health of a human subject, respectively for monitoring a set of critical medical parameters (blood glucose, cholesterol, blood pressure, pulse and oxygen saturation) while the diagnosis is made based on the application supplied results. The field of artificial intelligence is a very wide one, providing to the user a set of various techniques such as: fuzzy logic, artificial neural networks, adaptive neuro-fuzzy systems, expert systems, data mining, genetic algorithms. To develop the application software (the necessary decision rules, in fact the fuzzy rules) was used one of the most efficient (due to the multiple advantages supplied by the usage of fuzzy logic together with artificial neural networks) artificial intelligence technique, respectively the neuro-fuzzy inference systems, while the application interface was developed using the Visual Studio programming environment (respectively the C# language). A set of simulation results related to the developed application are presented for different test cases, such as: a healthy human subject, a human subject with diabetes, a human subject with high cholesterol, with high blood pressure, with lower level of blood oxygen and also with hypoxemia.
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- 2020
3. An Innovative Method for Predicting and Classifying Inadequate Accuracy in Heart Disease by Using Decision Tree with K-Nearest Neighbors Algorithm.
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Rajesh, Mandhapati and Malathi, K.
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DECISION trees , *K-nearest neighbor classification , *SUPERVISED learning , *HEART diseases , *ALGORITHMS , *MACHINE learning - Abstract
Aim: Predicting the Heartdiseases using medical parameters of cardiac patients to get a good accuracy rate using machine learning methods like innovative Decision Tree (DT) algorithm. Materials and Methods: Supervised Machine learning Techniques with innovative Decision Tree (N = 20) and K Nearest Neighbour (KNN) (N = 20) are performed with five different datasets at each time to record five samples. Results: The Decision Tree is used to predict heart disease with the help of various medical conditions, the accuracy is achieved for DT is 98% and KNN is 72.2%. The two algorithms Decision Tree and KNN are statistically insignificant (=.737) with the independent sample T-Test value (p<0.005) with a confidence level of 95%. Conclusion: Prediction and classification of heart disease significantly seem to be better in DT than KNN. [ABSTRACT FROM AUTHOR]
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- 2021
- Full Text
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4. Improving acute stroke care in regional hospitals: clinical evaluation of the Victorian Stroke Telemedicine program.
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Cadilhac D.A., Rabl J., O'Shea M., Groot P., Bolitho L., Campbell B.C.V., Dewey H.M., Donnan G.A., Vu M., Bladin C.F., Kim J., Bagot K.L., Moloczij N., Denisenko S., Price C., Pompeani N., Arthurson L., Hair C., Cadilhac D.A., Rabl J., O'Shea M., Groot P., Bolitho L., Campbell B.C.V., Dewey H.M., Donnan G.A., Vu M., Bladin C.F., Kim J., Bagot K.L., Moloczij N., Denisenko S., Price C., Pompeani N., Arthurson L., and Hair C.
- Abstract
Objectives: To evaluate the impact of the Victorian Stroke Telemedicine (VST) program during its first 12 months on the quality of care provided to patients presenting with suspected stroke to hospitals in regional Victoria. Design(s): Historical controlled cohort study comparing outcomes during a 12-month control period with those for the initial 12 months of full implementation of the VST program at each hospital. Setting(s): 16 hospitals in regional Victoria that participated in the VST program between 1 January 2010 and 30 January 2016. Participant(s): Adult patients with suspected stroke presenting to the emergency departments of the participating hospitals. Main Outcome Measure(s): Indicators for key processes of care, including symptom onset-to-arrival, door-to-first medical review, and door-to-CT times; provision and timeliness of provision of thrombolysis to patients with ischaemic stroke. Result(s): 2887 patients with suspected stroke presented to participating emergency departments during the control period, 3178 during the intervention period; the patient characteristics were similar for both periods. A slightly larger proportion of patients with ischaemic stroke who arrived within 4.5 hours of symptom onset received thrombolysis during the intervention than during the control period (37% v 30%). Door-to-CT scan time (median, 25 min [IQR, 13-49 min] v 34 min [IQR, 18-76 min]) and door-to-needle time for stroke thrombolysis (73 min [IQR, 56-96 min] v 102 min [IQR, 77-128 min]) were shorter during the intervention. The proportions of patients who received thrombolysis and had a symptomatic intracerebral haemorrhage (4% v 16%) or died in hospital (6% v 20%) were smaller during the intervention period. Conclusion(s): Telemedicine has provided Victorian regional hospitals access to expert care for emergency department patients with suspected acute stroke. Eligible patients with ischaemic stroke are now receiving stroke thrombolysis more quickly and safely.Cop
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- 2020
5. Epileptic seizures in cerebral venous sinus thrombosis: Subgroup analysis of VENOST study
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Birsen Ince, Serkan Demir, Seden Demirci, Hamit Genc, Hakan Ekmekçi, Hesna Bektas, Gülnur Tekgöl Uzuner, Bijen Nazliel, Taskin Gunes, Nevzat Uzuner, Uygar Utku, Taskin Duman, Ozge Yilmaz Kusbeci, Nilgun Cinar, Mustafa Bakar, Hakan Tekeli, Ahmet Tufekci, Nida Tascilar, Ali Yavuz Karahan, Derya Uluduz, Vedat Ali Yürekli, Hayriye Kucukoglu, Dilek Necioglu Orken, Eylem Ozaydin Goksu, Nilufer Yesilot, Mustafa Acikgoz, Ipek Midi, Hasan Hüseyin Kozak, Arda Yilmaz, Mustafa Gokce, Mehmet Ali Sungur, Hale Zeynep Batur Caglayan, Firdevs Ezgi Ucan Tokuc, Sena Colakoglu, Nazire Afsar, Necdet Mengulluoglu, Serdar Oruc, Yüksel Kablan, Ufuk Aluclu, Baki Göksan, Fatih Ozdag, Aysel Milanlioglu, Mehmet Yaman, Murat Cabala, Osman Özgür Yalın, Fusun Mayda Domac, Vildan Yayla, Cemile Handan Misirli, Başak Karakurum Göksel, Hatice Kurucu, Sevim Baybaş, Şerefnur Öztürk, Sevki Sahin, Mehmet Güney Şenol, Emrah Aytaç, Uluduz, Derya, Midi, Ipek, Duman, Taskin, Yayla, Vildan, Karahan, Ali Yavuz, Afsar, Nazire, Goksu, Eylem Ozaydin, Mengulluoglu, Necdet, Aytac, Emrah, Sungur, Mehmet Ali, Yesilot, Nilufer, Ince, Birsen, Yalin, Osman Ozgur, Oruc, Serdar, Senol, Mehmet Guney, Yilmaz, Arda, Gokce, Mustafa, Demirci, Seden, Kusbeci, Ozge Yilmaz, Uzuner, Gulnur, Caglayan, Hale Zeynep Batur, Acikgoz, Mustafa, Kurucu, Hatice, Ozdag, Fatih, Baybas, Sevim, Ekmekci, Hakan, Cabala, Murat, Yaman, Mehmet, Yurekli, Vedat Ali, Tekeli, Hakan, Genc, Hamit, Utku, Uygar, Sahin, Sevki, Tokuc, Firdevs Ezgi Ucan, Uzuner, Nevzat, Bektas, Hesna, Kablan, Yuksel, Goksel, Basak Karakurum, Milanlioglu, Aysel, Orken, Dilek Necioglu, Aluclu, Ufuk, Colakoglu, Sena, Tufekci, Ahmet, Bakar, Mustafa, Nazliel, Bijen, Tascilar, Nida, Goksan, Baki, Kozak, Hasan Huseyin, Demir, Serkan, Misirli, Cemile Handan, Kucukoglu, Hayriye, Cinar, Nilgun, Domac, Fusun Mayda, Ozturk, Serefnur, Gunes, Taskin, Maltepe Üniversitesi, Tıp Fakültesi, [Belirlenecek], Acibadem University Dspace, Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı., and EKN-8251-2022
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Male ,Neurologic disease ,Pediatrics ,Focal neurologic deficit ,Oral contraceptive agent ,Cerebral venous sinus thrombosis ,Cerebral hemorrhage ,Epilepsy ,0302 clinical medicine ,Observational study ,Middle aged ,Cerebrovascular disease ,Priority journal ,Medical parameters ,Brain radiography ,General Medicine ,Brain hemorrhage ,Prognosis ,Seizure ,Thrombosis ,Multicenter study ,Clinical trial ,Nuclear magnetic resonance imaging ,Retrospective study ,PUERPERIUM ,PREGNANCY ,Neurology ,Brain vein ,Clinical neurology ,Cohort ,Cerebral infarction ,Subgroup analysis ,Female ,Cohort analysis ,Infection ,Sinus thrombosis, intracranial ,Brain infarction ,Human ,Adult ,medicine.medical_specialty ,Family history ,Early seizure ,Neuroimaging ,Consciousness disorders ,Major clinical study ,Neurosciences & neurology ,Pathophysiology ,Article ,Cortical vein ,03 medical and health sciences ,Magnetic resonance imaging ,Age ,Seizures ,medicine ,Humans ,In patient ,Prospective study ,Demography ,Disease duration ,Cerebral Sinus Thrombosis ,Vein Thrombosis ,Superior Sagittal Sinus ,Consciousness disorder ,business.industry ,Neurosciences ,Methodology ,VEIN ,Gender ,Anticonvulsive agent ,medicine.disease ,Retrospective studies ,Malignant neoplasm ,SSS ,Clinical feature ,Sagittal sinus thrombosis ,Cerebral sinus thrombosis ,RISK-FACTORS ,Risk factor ,Neurology (clinical) ,business ,Prospective studies ,Controlled study ,Complication ,030217 neurology & neurosurgery - Abstract
Çalışmada 38 yazar bulunmaktadır. Bu yazarlardan sadece Bursa Uludağ Üniversitesi mensuplarının girişleri yapılmıştır. Purpose: The aim of this study is to evaluate the presence and prognostic impact of early seizures in cerebral venous sinus thrombosis patients (CVST). Method: VENOST is a retrospective and prospective national multicenter observational study. CVST patients with or without epileptic seizures (ES) were analyzed and compared in terms of demographic and imaging data, causative factors, clinical variables, and prognosis in a total of 1126 patients. Results: The mean age of the patients in the ES group was 39.73 +/- 12.64 and 40.17 +/- 14.02 years in the non-ES group (p > 0.05). Epileptic seizures were more common (76.6 %) in females (p < 0.001). Early ES occurred in 269 of 1126 patients (23.9 %). Epileptic seizures mainly presented in the acute phase (71.4 %) of the disease (p < 0.001). Majority of these (60.5 %) were in the first 24 h of the CVST. The most common neurological signs were focal neurologic deficits (29.9 %) and altered consciousness (31.4 %) in the ES group. Superior sagittal sinus (SSS) and cortical veins (CV) involvement were the most common sites of thrombosis and the mostly related etiology were found puerperium in seizure group (30.3 % vs 13.9 %). Patients with seizures had worse outcome in the first month of the disease (p < 0.001) but these did not have any influence thereafter. Conclusions: In this largest CVST cohort (VENOST) reported female sex, presence of focal neurological deficits and altered consciousness, thrombosis of the SSS and CVs, hemorrhagic infarction were risk factors for ES occurrence in patients with CVST.
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- 2020
6. The effects of vibration on efficiency in off-road cyclists
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Ozgur Ozkaya, Arzu On, Tolga Akşit, Gorkem Aybars Balci, and Ege Üniversitesi
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cycling ,off road cyclist ,workload ,human experiment ,beta elastomer ,lung gas exchange ,heart rate ,Graded exercise test ,Borg dyspnea scale ,Respiratory exchange ratio ,endurance ,Rating of perceived exertion ,exercise ,adult ,Rehabilitation ,mountain biking ,oxygen consumption ,Oxygen uptake ,unclassified drug ,volume of carbon dioxide output ,respiratory tract parameters ,volume of oxygen uptake ,young adult ,Original Article ,vibration ,Cycling ,ventilation threshold ,performance ,prospective study ,medicine.medical_specialty ,medical parameters ,whole body vibration training ,Physical Therapy, Sports Therapy and Rehabilitation ,Article ,whole body vibration ,male ,exhaustion ,Heart rate ,medicine ,polyester ,cyclist ,human ,normal human ,Gross efficiency ,business.industry ,carbon dioxide ,physical performance ,Vibration ,oxygen uptake ,Physical therapy ,bicycle exercise test ,athletic performance ,business ,human activities - Abstract
Objectives: The aim of this study was to investigate whether vibration significantly affected the efficiency of off-road cyclists. Patients and methods: Eight male mountain cyclists (mean age 21.1-1 years; range, 19 to 22 years) between August 2017 and November 2017 were included. The experimental protocol included four testing sessions with a one-day interval between testing sessions: A familiarization session; performance of submaximal tests; performance of maximal graded exercise test; and a 30-min mountain bike trial performed with vibration or without vibration. Physiological measures including volume of oxygen uptake (VO2), volume of carbon dioxide output (VCO2), VO2, VCO2, heart rate, respiratory exchange ratio, rating of perceived exertion, and gross efficiency (GE) were compared between the trials performed with vibration or without vibration. Results: There was a significant increase in the GE with the addition of intermittent vibration, particularly over the last 15 min of the cycling trial (p 0.05). There were no significant effects of vibration on other parameters. Conclusion: This study demonstrates that addition of intermittent vibration may provide positive benefits in improving GE during a 30-min submaximal cycling trial. © 2021 Turkish Society of Physical Medicine and Rehabilitation. All rights reserved.
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- 2019
7. An observational, prospective, multicenter study on rescue high-frequency oscillatory ventilation in neonates failing with conventional ventilation
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Omer Erdeve, Emel Okulu, Gaffari Tunc, Yalcın Celik, Ugur Kayacan, Merih Cetinkaya, Gokhan Buyukkale, Hilal Ozkan, Nilgun Koksal, Mehmet Satar, Mustafa Akcali, Canan Aygun, Servet Ozkiraz, Umut Zubarioglu, Sezin Unal, Hatice Turgut, Kurthan Mert, Tulin Gokmen, Barıs Akcan, Begum Atasay, Saadet Arsan, Rescue-HFOV Trial Group, Bursa Uludağ Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri/Çocuk Sağlığı Ve Hastalıkları Bölümü., Özkan, Hilal, Köksal, Nilgün, OMÜ, and Çukurova Üniversitesi
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Male ,Science & technology - other topics ,Intermittent positive pressure ventilation ,Turkey ,medicine.medical_treatment ,Failure ,Patent ductus arteriosus ,Social Sciences ,Procedures ,Pediatrics ,Trial ,High frequency ventilation ,Families ,Sociology ,Observational study ,Medicine ,Birth Weight ,Prospective Studies ,Children ,education.field_of_study ,Medical parameters ,Schools ,Clinical outcome ,Respiration ,Lung Injury ,Neonatal respiratory distress syndrome ,Arterial gas ,Multicenter study ,Management ,Clinical trial ,High-Frequency Ventilation ,Ventilator-Induced Lung Injury ,Artificial Ventilation ,Chronic lung disease ,Breathing ,Population study ,Engineering and Technology ,Factor analysis ,Human ,Death Rates ,Science ,Major clinical study ,Article ,Treatment duration ,Education ,Neonatal intensive care unit ,Population Metrics ,Intensive care ,Intensive Care Units, Neonatal ,Humans ,education ,Demography ,Biology and Life Sciences ,Neonates ,Infant ,Nitric oxide ,Respiration, Artificial ,Population Groupings ,Extracorporeal oxygenation ,Neonatology ,Complication ,Reference value ,Developmental Biology ,Data base ,Respiratory failure ,Intermittent Positive-Pressure Ventilation ,Mechanical ventilation ,Artificial ventilation ,Arterial oxygen saturation ,Controlled clinical trial ,Turkey (bird) ,Medicine and Health Sciences ,Prospective cohort study ,Multidisciplinary ,Congenital diaphragmatic-hernia ,Gestational age ,Brain hemorrhage ,Register ,Laboratory Equipment ,Multidisciplinary Sciences ,Air conditioning ,Anesthesia ,Newborn mortality ,High frequency oscillatory ventilation ,Female ,Respiratory Insufficiency ,Infants ,Research Article ,Term infants ,Population ,Ventilators ,Equipment ,Gestational Age ,Lung injury ,Blood gas analysis ,Extracorporeal Membrane Oxygenation ,Extracorporeal membrane oxygenation ,Prospective study ,Mortality ,Disease severity ,Respiratory Distress Syndrome, Newborn ,Retrolental fibroplasia ,Population Biology ,business.industry ,Infant, Newborn ,Newborn ,Online system ,Ventilation ,Age Groups ,People and Places ,Low birth weight ,business ,Controlled study - Abstract
Atasay, Fatma Begum/0000-0002-9114-5293; AYGUN, CANAN/0000-0002-7955-5943; Okulu, Emel/0000-0002-1101-3355; ERDEVE, OMER/0000-0002-3193-0812 WOS: 000470854200027 PubMed: 31181092 Background To achieve gas exchange goals and mitigate lung injury, infants who fail with conventional ventilation (CV) are generally switched to high-frequency oscillatory ventilation (HFOV). Although preferred in many neonatal intensive care units (NICUs), research on this type of rescue HFOV has not been reported recently. Methods An online registry database for a multicenter, prospective study was set to evaluate factors affecting the response of newborn infants to rescue HFOV treatment. The study population consisted of 372 infants with CV failure after at least 4 hours of treatment in 23 participating NICUs. Patients were grouped according to their final outcome as survived (Group S) or as died or received extracorporeal membrane oxygenation (ECMO) (Group D/E). Patients' demographic characteristics and underlying diseases in addition to their ventilator settings, arterial blood gas (ABG) analysis results at 0, 1, 4, and 24 hours, type of device, ventilation duration, and complications were compared between groups. Results HFOV as rescue treatment was successful in 58.1% of patients. Demographic and treatment parameters were not different between groups, except that infants in Group D/E had lower birthweight (BW) (1655 +/- 1091 vs. 1858 +/- 1027 g, p = 0.006), a higher initial FiO2 setting (83% vs. 72%, p < 0.001), and a higher rate of nitric oxide exposure (21.8% vs. 11.1%, p = 0.004) in comparison to infants who survived (Group S). The initial cut-offs for a successful response on ABG were defined as pH > 7.065 (OR: 19.74, 95% CI 4.83-80.6, p < 0.001), HCO3 > 16.35 mmol/L (OR: 1.06, 95% CI 1.01-1.1, p = 0.006), and lactate level < 3.75 mmol/L (OR: 1.09% 95 CI 1.01-1.16, p = 0.006). Rescue HFOV duration was associated with retinopathy of prematurity (p = 0.005) and moderate or severe chronic lung disease (p < 0.001), but not with patent ductus arteriosus or intraventricular hemorrhage, in survivors (p > 0.05). Conclusion Rescue HFOV as defined for this population was successful in more than half of the patients with CV failure. Although the response was not associated with gestational age, underlying disease, device used, or initial MV settings, it seemed to be more effective in patients with higher BW and those not requiring nitric oxide. Initial pH, HCO3, and lactate levels on ABG may be used as predictors of a response to rescue HFOV. Turkish Neonatal Society [5-2016] This study was supported by the Turkish Neonatal Society, number 5-2016, received by OE. Turkish Neonatal Society funded the study's online registry system. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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- 2019
8. Pulmonary function, aerobic capacity and related variables in patients with ankylosing spondylitis
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Macit Kalçık, Yusuf Karavelioğlu, Çağliyan Türk A, Fusun Sahin, Arslan S, Sumru Özel, Ahmet Musmul, Çağlıyan Türk, Ayla, Arslan, Sertaç, Kalçık, Macit, and Özel, Sumru
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Bath ankylosing spondylitis disease activity index ,Ankylosing Spondylitis ,peak expiratory flow ,spirometry ,spine mobility ,functional status ,Metabolic equivalent ,Pulmonary function testing ,workload ,Pulmonary Function Test ,0302 clinical medicine ,Quality of life ,heart rate ,030212 general & internal medicine ,C reactive protein ,exercise ,adult ,Pulmonary function test ,VO2 max ,Ankylosing Spondylitis Quality of Life ,forced expiratory volume ,metabolic equivalent ,oxygen consumption ,aged ,female ,Cardiology ,Original Article ,medicine.symptom ,cardiopulmonary exercise test ,medicine.medical_specialty ,medical parameters ,Ankylosing Spondylitis Quality of Life Questionnaire ,electrocardiography ,Article ,03 medical and health sciences ,Rheumatology ,male ,Bath Ankylosing Spondylitis Metrology Index ,forced vital capacity ,Internal medicine ,Heart rate ,ankylosing spondylitis ,medicine ,controlled study ,human ,bicycle ergometry ,030203 arthritis & rheumatology ,Ankylosing spondylitis ,cardiopulmonary function ,Cardiopulmonary Exercise Testing ,occiput to wall distance ,business.industry ,questionnaire ,Enthesitis ,hemoglobin ,medicine.disease ,major clinical study ,Cardiopulmonary exercise testing ,aerobic capacity ,disease assessment ,Maastricht Ankylosing Spondylitis Enthesitis Score ,age ,Bath ankylosing spondylitis functional index ,Quality of Life ,erythrocyte sedimentation rate ,blood cell count ,business ,disease activity - Abstract
Objectives: This study aims to evaluate the cardiopulmonary functions and exercise performance of patients with ankylosing spondylitis (AS) and to investigate the relationship between these parameters and disease activity, spine mobility and quality of life (QoL). Patients and methods: Forty-five patients with AS (group 1; 33 males, 12 females; mean age 43.1±12.1 years; range 22 to 70 years) and 30 control subjects (group 2; 23 males, 7 females; mean age 42.8±10.0; range 23 to 70 years) were included in the study. Disease activity was assessed with the Bath Ankylosing Spondylitis Disease Activity Index and spinal mobility measures with the Bath Ankylosing Spondylitis Metrology Index (BASMI). The Ankylosing Spondylitis Quality of Life (ASQoL) Questionnaire and the Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) were used. The pulmonary function test (PFT) and cardiopulmonary exercise testing (CPET) were performed. Results: There was no significant difference between groups 1 and 2 in terms of mean age. The peak expiratory flow value in PFT was significantly lower in group 1 (p
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- 2019
9. The impact of sleep disordered breathing on cardiovascular health in overweight children.
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Tamanyan K., Weichard A., Odoi A., Biggs S.N., Davey M.J., Nixon G.M., Walter L.M., Horne R.S.C., Shandler G., Tamanyan K., Weichard A., Odoi A., Biggs S.N., Davey M.J., Nixon G.M., Walter L.M., Horne R.S.C., and Shandler G.
- Abstract
Background Up to 50% of overweight/obese children have obstructive sleep apnea (OSA) compared to up to 6% of normal weight children. We compared cardiovascular variables between normal weight and overweight/obese children with and without OSA, and controls. Methods Seventy-four referred children and 24 normal weight non-snoring controls (8-18 years) were recruited. Referred children were grouped according to their obstructive apnea hypopnea index (OAHI): OSA (>1 event/h) or primary snoring (PS <= 1 event/h) and whether they were normal weight (BMI z-score <1.04) or overweight/obese (BMI z-score >= 1.04). Wake blood pressure (BP), heart rate (HR), and pulse transit time (PTT, an inverse continuous surrogate measure of blood pressure) during sleep were recorded. Results Wake BP was higher in the overweight/obese OSA group than in the control, normal weight PS, and overweight/obese PS groups (p < 0.05 for all). During sleep, BP, and HR were elevated in the overweight/obese OSA group compared to those in non-snoring controls (p < 0.05). More children who were overweight/obese had reduced BP and HR dipping from wake to sleep than normal weight children. The BMI z-score predicted HR and PTT when asleep and both age and BMI z-score predicted BP when awake. Conclusion This study showed that BMI has both combined and independent effects on BP and HR in children with OSA. We have previously shown that treatment of OSA reduces BP and suggest that treatment of OSA in the growing number of overweight/obese children may improve cardiovascular outcomes.Copyright © 2017
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- 2018
10. Definition and initial validation of a Lupus Low Disease Activity State (LLDAS).
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Morand E.F., Chen S.L., Jin O., Morton S., Hoi A., Huq M., Nikpour M., Franklyn K., Lau C.S., Navarra S.V., Louthrenoo W., Lateef A., Hamijoyo L., Wahono C.S., Morand E.F., Chen S.L., Jin O., Morton S., Hoi A., Huq M., Nikpour M., Franklyn K., Lau C.S., Navarra S.V., Louthrenoo W., Lateef A., Hamijoyo L., and Wahono C.S.
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Aims Treating to low disease activity is routine in rheumatoid arthritis, but no comparable goal has been defined for systemic lupus erythematosus (SLE). We sought to define and validate a Lupus Low Disease Activity State (LLDAS). Methods A consensus definition of LLDAS was generated using Delphi and nominal group techniques. Criterion validity was determined by measuring the ability of LLDAS attainment, in a single-centre SLE cohort, to predict non-accrual of irreversible organ damage, measured using the Systemic Lupus International Collaborating Clinics Damage Index (SDI). Results Consensus methodology led to the following definition of LLDAS: (1) SLE Disease Activity Index (SLEDAI)-2K <=4, with no activity in major organ systems (renal, central nervous system (CNS), cardiopulmonary, vasculitis, fever) and no haemolytic anaemia or gastrointestinal activity; (2) no new lupus disease activity compared with the previous assessment; (3) a Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA)-SLEDAI physician global assessment (scale 0-3) <=1; (4) a current prednisolone (or equivalent) dose <=7.5 mg daily; and (5) well tolerated standard maintenance doses of immunosuppressive drugs and approved biological agents. Achievement of LLDAS was determined in 191 patients followed for a mean of 3.9 years. Patients who spent greater than 50% of their observed time in LLDAS had significantly reduced organ damage accrual compared with patients who spent less than 50% of their time in LLDAS (p=0.0007) and were significantly less likely to have an increase in SDI of >=1 (relative risk 0.47, 95% CI 0.28 to 0.79, p=0.005). Conclusions A definition of LLDAS has been generated, and preliminary validation demonstrates its attainment to be associated with improved outcomes in SLE.Copyright © 2016 Published by the BMJ Publishing Group Limited.
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- 2016
11. Subgingival microbiota in health compared to periodontitis and the influence of smoking
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Camelo-Castillo AJ, Mira A, Pico A, Nibali L, Henderson B, Donos N, and Tomás I
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medical parameters ,polymerase chain reaction ,Anaeroglobus ,Haemophilus ,tooth plaque ,bleeding on probing ,Article ,smoking ,Veillonella ,TM7 ,male ,Gemella ,controlled study ,Treponema ,human ,Porphyromonas ,Filifactor ,clinical attachment level ,DNA extraction ,periodontitis ,Bacteria (microorganisms) ,Leptotrichia ,Tannerella ,nonhuman ,Mogibacterium ,Eubacterium ,Peptostreptococcus ,adult ,mouth flora ,Bulleidia extructa ,Streptococcus ,Desulfobulbus ,chronic periodontitis ,Granulicatella adiacens ,Schwartzia (Bacteria) ,Fusobacterium ,major clinical study ,Paenibacillus durus ,female ,pyrosequencing ,Bulleidia ,microbial diversity ,probing pocket depth ,Capnocytophaga - Abstract
The etiology of periodontitis has traditionally been associated to a consortium of three bacterial species-the so-called "red-complex" of periodontal disease-which has been the target for most diagnostic and therapeutic strategies. However, other species have also been found to correlate with disease severity. In addition, the influence of smoking on periodontal microbiota is poorly understood. In the current manuscript, the composition of the subgingival microbiota in healthy individuals vs. patients with chronic periodontitis has been investigated using 16S pyrosequencing and the influence of smoking on periodontal composition has been examined. Subgingival bacterial communities were sampled from 82 patients: 22 non-smoking healthy controls, 28 non-smoking periodontal patients, and 32 smoking periodontal patients. Bacterial diversity was higher in periodontal patients than in healthy subjects, which could be interpreted as the consequence of a nutritionally richer environment or a reduced immune competence. Periodontal patients showed a significantly higher prevalence/relative abundance of "established" periopathogens but also other taxa whose role is not well-established and that should be targets for future research. These include Anaeroglobus, Bulleidia, Desulfobulbus, Filifactor, Mogibacterium, Phocaeicola, Schwartzia or TM7. The microbial community of smoking-associated periodontitis is less diverse and distinct from that of non-smokers, indicating that smoking has an influence on periodontal ecology. Interestingly, the high sequencing coverage allowed the detection at low proportions of periodontal pathogens in all healthy individuals, indicating that chronic periodontitis cannot be strictly considered an infectious disease but the outcome of a polymicrobial dysbiosis, where changes in the proportions of microbial consortia trigger the inflammatory and tissue-degradation responses of the host. © 2015 Camelo-Castillo, Mira, Pico, Nibali, Henderson, Donos and Tomás.
- Published
- 2015
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