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Objective: The aim of this study was to describe burden of care related to monitoring patient vital signs of intensive care unit patients in a Swedish hospital. Setting: Data collected by “The Swedish Intensive Care Registry” from one general category II intensive care unit in a Swedish hospital was included in this study. Data from year 2014 to 2020 was analysed comprising a total of 3617 intensive care episodes and 29,165 work shifts. Research methodology: This is a retrospective database study. Descriptive statistics gave an overview of the dataset. To test for differences between variables related to burden of care for “Documentation of monitoring” Mann Whitney U test and Kruskal Wallis test was performed using STATA. Results: “Documentation of monitoring” was reported to generate a prominent burden of care during intensive care. Nearly all patients had continuous monitoring. Comparison for burden of care related to “Documentation of monitoring” for sexes generated no statistically significant difference. Comparison for burden of care related to “Documentation of monitoring” among age groups, diagnose groups and time of day generated statistically significant differences. Conclusion: Monitoring patient vital signs was clearly present during intensive care, hence impacting intensive care nurses’ clinical practice. Further research is endorsed to improve and facilitate monitoring to keep improving patient safety. CC BY 4.0Correspondence Address: Romare, C.; Blekinge Institute of Technology, Attn: Charlotte Romare, Lumavägen 1, Sweden; email: charlotte.romare@bth.seThis work was funded by Blekinge Institute of Technology, Sweden. The funder had no role in any part of the study or preparation of the manuscript.Available online 17 February 2022

It is a known fact that diabetes can mostly be prevented or delayed with health-promoting and protective lifestyle changes in people at high risk of diabetes. In addition, awareness of the risk of diabetes in the relatives of individuals with diabetes may also contribute to the prevention of the disease. This study was carried out to determine the relationship between perceived and actual diabetes risk level with promotive and protective health behaviors in relatives of individuals with type 2 diabetes. This cross-sectional study included 596 individuals. Of the participants, 62.7% stated that they perceive their risk of developing diabetes at a high-very high level in the next 10 years. The participants had promotive and protective health behaviors at a moderate level. No significant difference was found between the perceived diabetes risk level and promotive and protective health behaviors. Health professionals should take more responsibility for risk identification and risk management. © 2022 by Author/s and Licensed by Modestum.

Background: Corneal and lenticular optical properties are not well-documented in pediatric patients with inflammatory diseases. Here we aimed to evaluate corneal and lenticular optical density as well as corneal morphology in children with ocular and/or systemic inflammation by Scheimpflug imaging. Methods: Fifty-five eyes of 29 children with non-infectious uveitis, 56 eyes of 28 children with systemic inflammation without uveitis and 60 eyes of 31 healthy children were included. Corneal/lenticular optical density, corneal volume, central corneal thickness, keratometry were analyzed by Pentacam HR. Corneal endothelial cell density, hexagonal cell ratio and coefficient of variation were measured by specular microscope. Results: The mean age was 12.0 ± 3.1 years, 11.9 ± 4.0 years and 11.3 ± 3.4 years whereas the female/ratio was 15/14, 15/13 and 14/17 in uveitis, systemic inflammation and control groups respectively. Uveitis type was anterior uveitis in 16 (29.1%) eyes, intermediate uveitis in 32 (58.2%) eyes and panuveitis in 7 (12.7%) eyes. Twenty-two (40%) eyes had active uveitis whereas 33 (60%) eyes had inactive uveitis. Corneal optical density was greater in uveitis group compared with other groups (p = 0.001, Kruskal-Wallis test). Lenticular density and corneal parameters other than optical density were not different between the groups (p > 0.05). Corneal optical density was higher in active uveitis than inactive uveitis (22/33 eyes, p = 0.017). Conclusion: Children with uveitis had decreased corneal clarity compared with systemic inflammation group and healthy controls, while lenticular clarity was similar between the groups. Corneal endothelial parameters did not change significantly based on ocular/systemic inflammation. Scheimpflug imaging provides objective corneal and lenticular optical density measurements. © 2022

Background: TNFα inhibitors are the first line biological treatment for patients suffering from rheumatic diseases (RD) and inflammatory bowel disease (IBD). Limited information is available about long-term treatment patterns of patients starting a TNFα inhibitor and whether these differ between patients suffering from RD and IBD. Objectives: To compare treatment patterns of patients with RD and IBD starting a TNFα inhibitor. Methods: Included were all patients starting (i.e. no prior use of a biological) with aTNFα inhibitor (ATC code: L04AB) between 1 July 2012 and 1 July 2017 at a Dutch general teaching hospital (the Spaarne Gasthuis, Haarlem/Hoofddorp) and with a RD or IBD diagnosis. All patients were followed for at least one year. Outcomes at one year of follow-up were: continuous use of the first TNFα inhibitor, switch to a different TNFα inhibitor or to a biological with another mode of action, or discontinuation. In addition, median duration of first TNFα inhibitor treatment were compared for patients with RD and IBD using the Kaplan Meier method. Data were analyzed by Pearson's chi square and Kruskal Wallis test. Results: 646 patients were included (median age 46 years, 84% female), of which 63.9% (n = 413) received a TNFα inhibitor for RD and 36.1% (n = 233) for IBD. After 1 year, 60.1% of patients continuously used their first TNFα inhibitor, 13.4% switched to another biological and 26.5% discontinued treatment. Significantly less RD patients continued their TNFα inhibitor compared to IBD patients (54.4% versus 70.0%, RR 0.78, 95% CI 0.69-0.88) and RD patients discontinued treatment more frequently than IBD patients (33.0% versus 15.0%, RR 2.19, 95% CI 1.57-3.06). 12.6% of RD patients and 15.0% of IBD patients had switched, most patients (71.1% of RD switchers and 91.4% of IBD switchers) to a second TNFα inhibitor. The median treatment duration of the first TNFα inhibitor was significantly (p

The purpose of this study was to investigate the usefulness of diffusion-weighted imaging (DWI) in the detection of different degrees of testicular torsion (TT) at the 8th hour and testicular salvageability at the 24th hour of torsion.31 rats were randomly classified into 4 groups. In Group 1 (sham-control group), the left testicle was kept outside and replaced. Left testicles were kept outside and twisted 360° in Group 2, 720° in Group 3 and 1080° in Group 4. Later, DWI was performed at 8th and 24th hours. After DWI, bilateral radical orchiectomy and histopathological examination were performed. Apparent diffusion coefficient (ADC) maps were obtained with b-factors of 0 and 800 s mmSensitivity of DWI in the diagnosis of TT was 12.5% for 360° torsion, 100% for 720° torsion and 1080° torsion at the 8th hour of torsion. Mean ADC values of the left testicles increased significantly at the 24th hour of torsion in Groups 3 and 4. All testicles in Groups 3 and 4 were observed to be irrecoverable on histopathological examination.Increased ADC values in the affected testicle may represent irreversible tissue damage. So, immediate surgery is not required at this stage, which may reduce morbidity and mortality caused by immediate surgery and anaesthesia. Advances in knowledge: TT can be diagnosed easily by DWI without administrating any contrast material. DWI findings in the affected testicle may represent testicular salvageability.

Epineural stitches are a means to avoid tension in a nerve suture. We evaluate this technique, relative to interposed grafts and simple neurorraphy, in a rat model. Method: Twenty rats were allocated to four groups. For Group 1, sectioning of the sciatic nerve was performed, a segment 4 mm long discarded, and epineural suture with distal anchoring stitches were placed resulting in slight tension neurorraphy. For Group 2, a simple neurorraphy was performed. For Group 3, a 4 mm long graft was employed and Group 4 served as control. Ninety days after, reoperation, latency of motor action potentials recording and axonal counts were performed. Inter-group comparison was done by means of ANOVA and the non-parametric Kruskal-Wallis test. Results: The mean motor latency for the simple suture (2.27±0.77 ms) was lower than for the other two surgical groups, but lower than among controls (1.69±0.56 ms). Similar values were founding in both group 1 (2.66±0.71 ms) and group 3 (2.64±0.6 ms). When fibers diameters were compared a significant difference was identified between groups 2 and 3 (p=0.048). Conclusion: Good results can be obtained when suturing a nerve employ with epineural anchoring stitches. However, more studies are needed before extrapolating results to human nerve sutures., Facultad de Ciencias Médicas

To quantitatively evaluate vertebral bone marrow fat content and investigate its association with osteoporosis with chemical-shift magnetic resonance imaging (CS-MRI). Fifty-six female patients (age range 50-65 years) with varying bone mineral densities as documented with dual x-ray absorptiometry (DXA) were prospectively included in the study. According to the DXA results, the patients were grouped as normal bone density, osteopenic, or osteoporotic. In order to calculate fat content, the lumbar region was visualized in the sagittal plane by CS-MRI sequence. "Region of interest" (ROI)s were placed within L3 vertebral bodies and air (our reference point) at different time points by different radiologists. Fat content was calculated through "signal intensity (SI) suppression rate" and "SI Index". The quantitative values were compared statistically with those obtained from DXA examinations. Kruskal-Wallis, and Mann-Whitney U tests were used for comparisons between groups. The reliability of the measurements performed by two radiologists was evaluated with the "intraclass correlation coefficient". This study was approved by an institutional review board and all participants provided informed consent to participate in the study. Eighteen subjects with normal bone density (mean T score, 0.39 +/- 1.3 [standard deviation]), 20 subjects with osteopenia (mean T score, -1.79 +/- 0.38), and 18 subjects with osteoporosis (mean T score, -3 +/- 0.5) were determined according to DXA results. The median age was 55.9 (age range 50-64 years) in the normal group, 55.5 (age range 50-64 years) in the osteopenic group, and 55.1 (age range 50-65 years) in the osteoporotic group (p = 0.872). In the CS-MRI examination, the values of "SI suppression ratio" and "SI Index" (median [min:max]) were calculated by the first and second reader, independently. There was no statistically significant difference between the groups with regard to vertebral bone marrow fat content (p > 0.05). According to the "intraclass correlation coefficient", the measurements were reliable (0.55 and 0.60). Vertebral bone marrow fat content calculated with CS-MRI is not a reliable parameter for predicting bone mineral density in female patients aged between 50 and 65 years.

Background: Caspase-cleaved cytokeratin 18 (CK18-Asp396) is released from hepatocytes during apoptosis. Recent studies have indicated that serum levels of CK18-Asp396 could be clinically useful biomarker of chronic liver disease. To shed more light on the rate of hepatocyte loss by apoptosis in chronic liver disease, serum levels of CK18-Asp396 were examined in patients with nonalcoholic steatohepatitis (NASH) and chronic hepatitis C. Material/Methods: Apoptotic CK18-Asp396 levels were quantified in sera from 35 patients with nonalcoholic steato-hepatitis (NASH), 21 patients with chronic hepatitis C (HCV), and 18 healthy controls. Results: Analysis of serum CK18-Asp396 levels showed an increasing trend starting from healthy controls (median: 34.5 U/l), to HCV patients (80.1 U/l), to patients with NASH (144.1 U/l. Kruskall-Wallis test: P

Objective: Endothelial dysfunction is an early marker of atherosclerosis. Angiotensin II and nitric oxide have important roles in maintaining the vascular tone. The existence of the angiotensin converting enzyme (ACE) gene polymorphisms has been known, and deletion (D) of the allele has been associated with coronary artery disease. As ACE genotype affects endothelial functions in the patients with risk factors for coronary artery disease, it may also be a determinant of atherosclerosis. In this study, the relationship between endothelial function and ACE gene polymorphisms was investigated in healthy young subjects. Methods: Forty-six healthy young subjects were included in this cross-sectional, randomized study. Participants were further divided into three groups according with ACE genotypes: DD genotype - 24 subjects, DI genotype - 13 subjects and II genotype - 9 subjects. All patients underwent brachial artery ultrasonographic examination. We analyzed ACE insertion (I) and D allele frequencies in all subjects. Kruskal-Wallis test was used to compare continuous variables, and the Chi-square test was used to compare proportions among groups. Results: Demographic features were similar except gender between the groups according to the ACE genotypes. Total cholesterol levels were lower in the DD genotype comparing with the others (p0.05). Endothelium independent dilatations were similar among different ACE genotypes. Conclusion: Our data showed that ACE genotype has no effect on endothelial functions in patients without risk factors for coronary artery disease.

Objective: Endothelial dysfunction is an early marker of atherosclerosis. Angiotensin II and nitric oxide have important roles in maintaining the vascular tone. The existence of the angiotensin converting enzyme (ACE) gene polymorphisms has been known, and deletion (D) of the allele has been associated with coronary artery disease. As ACE genotype affects endothelial functions in the patients with risk factors for coronary artery disease, it may also be a determinant of atherosclerosis. In this study, the relationship between endothelial function and ACE gene polymorphisms was investigated in healthy young subjects. Methods: Forty-six healthy young subjects were included in this cross-sectional, randomized study. Participants were further divided into three groups according with ACE genotypes: DD genotype - 24 subjects, DI genotype - 13 subjects and II genotype - 9 subjects. All patients underwent brachial artery ultrasonographic examination. We analyzed ACE insertion (I) and D allele frequencies in all subjects. Kruskal-Wallis test was used to compare continuous variables, and the Chi-square test was used to compare proportions among groups. Results: Demographic features were similar except gender between the groups according to the ACE genotypes. Total cholesterol levels were lower in the DD genotype comparing with the others (p0.05). Endothelium independent dilatations were similar among different ACE genotypes. Conclusion: Our data showed that ACE genotype has no effect on endothelial functions in patients without risk factors for coronary artery disease.

Caspase-cleaved cytokeratin 18 fragments (M30 antigen) can be detected in the circulation of patients with carcinoma and are believed to reflect cell death of tumors of epithelial origin. M30 antigens cleaved at Asp396 are detected using an epitope-specific antibody (M30 antibody). We here measured the levels of such fragments in patients with lung cancer (n = 60), patients with benign lung disease (n = 22) and healthy control subjects (n = 32). A statistically significant difference was observed between these groups (p