Poincaré plots to analyze photoplethysmography signal between non-smokers and smokers

<span>An analysis of blood circulation was used to identify variations of heart rate and to create an early warning system of autonomic dysfunction. The Poincaré plot analyzed blood circulation using photoplethysmography (PPG) signals between non-smokers and smokers in three different indices: SD1, SD2, and SD1 SD2 ratio (SSR). There were twenty subjects separated into non-smoker and smoker groups with sample sizes of 10, respectively. An independent sample t-test to compare the continuous variables. Whereas, the comparison between two groups employed Fisher’s exact test for categorical variables. The result showed that SD1 was found to be considerably lower in the group of smokers (0.03±0.01) than that of the non-smokers (0.06±0.03). Similarly, SSR was recorded at 0.0012±0.0005 and 0.0023±0.0012 for smoking and non-smoking subjects, respectively. As a comparison, SD2 for non-smokers (25.7±0.5) was lower than smokers (27.3±0.4). In conclusion, we revealed that the parameters of Poincaré plots (SD1, SD2, and SSR) exert good performances to significantly differentiate the PPG signals of the group of non-smokers from those of smokers. We also supposed that the method promises to be a suitable method to distinguish the cardiovascular disease group. Therefore, this method can be applied as a part of early detection system of cardiovascular diseases.</span>

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Pyelonephritis in Pregnancy: Prediction of Prolonged Hospitalization and Maternal Morbidity using Prognostic Scoring Systems

American Journal of Perinatology ◽

10.1055/s-0037-1602418 ◽

2017 ◽

Vol 34 (12) ◽

pp. 1212-1218 ◽

Cited By ~ 1

Author(s):

Katie Peticca ◽

Alexandra DiMatteo ◽

Shimeka Banks ◽

Ronak Shah ◽

Lindsey Chernicky ◽

...

Keyword(s):

Maternal Morbidity ◽

Area Under The Curve ◽

Warning System ◽

Scoring Systems ◽

Apache Ii ◽

Categorical Variables ◽

Continuous Variables ◽

Exact Test ◽

Prolonged Hospitalization ◽

Prognostic Scoring Systems

Objective This study aims to evaluate the usefulness of prognostic scoring systems to differentiate women admitted for pyelonephritis who develop maternal morbidity and require prolonged hospitalization. Study Design Multicenter retrospective cohort study to compare the Acute Physiology and Chronic Health Evaluation II (APACHE II) and Modified Obstetric Early Warning System (MOEWS) to predict prolonged hospitalization (> 4 days) and composite maternal morbidity for all pregnant women admitted with pyelonephritis between 2012 to 2013. One-way analysis of variance for continuous variables, Fisher's exact test for categorical variables, and receiver operating characteristic curves were used. Results Among 123 pyelonephritis cases analyzed, 25 (20%) required prolonged hospitalization. Women with prolonged hospitalization had higher rates of composite maternal morbidity, required diagnostic imaging, and had delayed administration of intravenous antibiotics (292 ± 381 vs. 218 ± 233 min, p = 0.002). APACHE II and MOEWS scores calculated from data collected within the first 24 hours of admission had a modest ability to discriminate maternal morbidity (APACHE II: area under the curve [AUC], 0.72; 95% confidence interval [CI], 0.58–0.86 and MOEWS: AUC, 0.71; 95% CI, 0.56–0.85). Conclusion We observed that one in five pregnancies admitted for treatment of pyelonephritis requires hospitalization for over 4 days with significant maternal morbidities. Prognostic scoring systems may be useful clinical tools to assess these patients systematically and improve morbidity.

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Long term prognostic implication of newly detected abnormal glucose tolerance among patients with stable cardiovascular disease: a population-based cohort study

Journal of Translational Medicine ◽

10.1186/s12967-021-02950-y ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Maryam Kabootari ◽

Samaneh Asgari ◽

Seyedeh Maryam Ghavam ◽

Hengameh Abdi ◽

Fereidoun Azizi ◽

...

Keyword(s):

Cardiovascular Disease ◽

Glucose Tolerance ◽

Plasma Glucose ◽

Population Based ◽

World Health ◽

Incident Diabetes ◽

Categorical Variables ◽

Continuous Variables ◽

Diabetes Status ◽

Adjusted Model

Abstract Background Fasting plasma glucose (FPG) and 2-h post challenge plasma glucose (2 h-PCPG), whether as continuous or categorical variables, are associated with incident cardiovascular disease (CVD) and diabetes; however, their role among patients with existing CVD is a matter of debate. We aimed to evaluate associations of different glucose intolerance states with recurrent CVD and incident diabetes among subjects with previous CVD. Methods From a prospective population-based cohort, 408 Iranians aged ≥ 30 years, with history of CVD and without known diabetes were included. Associations of impaired fasting glucose (IFG) according to the American Diabetes Association (ADA) and World Health Organization (WHO) criteria, impaired glucose tolerance (IGT), newly diagnosed diabetes (NDM) with outcomes of interest were determined by multivariable Cox proportional hazard models after adjustment for traditional risk factors. Furthermore, FPG and 2 h-PCPG were entered as continuous variables. Results Over a decade of follow-up, 220 CVD events including 89 hard events (death, myocardial infarction and stroke) occurred. Regarding prediabetes, only IFG-ADA was associated with increased risk of hard CVD [hazard ratio(HR), 95%CI: 1.62,1.03–2.57] in the age-sex adjusted model. In patients with NDM, those with FPG ≥ 7 mmol/L were at higher risk of incident CVD/coronary heart disease(CHD) and their related hard outcomes (HR ranged from 1.89 to 2.84, all P < 0.05). Moreover, those with 2 h-PCPG ≥ 11.1 mmol/L had significant higher risk of CVD (1.46,1.02–2.11), CHD (1.46,1.00–2.15) and hard CHD (1.95:0.99–3.85, P = 0.05). In the fully adjusted model, each 1 SD increase in FPG was associated with 20, 27, 15 and 25% higher risk of CVD, hard CVD, CHD and hard CHD, respectively; moreover each 1 SD higher 2 h-PCPG was associated with 21% and 16% higher risk of CVD, and CHD, respectively. Among individuals free of diabetes at baseline (n = 361), IFG-ADA, IFG-WHO and IGT were significantly associated with incident diabetes (all P < 0.05); significant associations were also found for FPG and 2 h-PCPG as continuous variables (all HRs for 1-SD increase > 2, P < 0.05). Conclusions Among subjects with stable CVD, NDM whether as high FPG or 2 h-PCPG, but not pre-diabetes status was significantly associated with CVD/CHD and related hard outcomes.

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OP0271 REAL-WORLD CLINICAL BURDEN AND GLUCOCORTICOID USE IN PATIENTS WITH POLYMYALGIA RHEUMATICA

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.4285 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 169.1-169

Author(s):

R. Punekar ◽

P. Lafontaine ◽

J. H. Stone

Keyword(s):

Cardiovascular Disease ◽

Health Plan ◽

Polymyalgia Rheumatica ◽

Data Availability ◽

Categorical Variables ◽

Continuous Variables ◽

Rank Tests ◽

Medical Claim ◽

Diagnosis Codes

Background:Polymyalgia rheumatica (PMR) is a chronic inflammatory condition characterized by aching and morning stiffness in the neck, shoulders and pelvic girdle. It is a common inflammatory rheumatic disease in patients age >50 years, particularly women. While giant cell arteritis (GCA) is present in 9–21% of PMR cases, many PMR patients have symptoms independent of GCA. Current treatment options are limited to long-term glucocorticoid (GC), however, with risks of GC-related complications, including cardiovascular disease, osteoporosis, and diabetes mellitus.Objectives:To compare GC use and subsequent GC-related complications in patients with PMR vs a general population (GnP) cohort.Methods:This retrospective, observational cohort study was based on Optum’s de-identified Clinformatics®Data Mart Database (study period 01Jan2006-30June2018). The PMR cohort included patients with ≥1 inpatient or ≥2 outpatient claims ≥30 days apart with PMR related diagnosis codes (ICD-9: 725.xx or ICD-10: M35.3x) between 01Jan2006–30June2017 (patient identification period) during which first occurrence of a PMR-related medical claim was set as the index date (ID). Patients with ≥1 medical claim related to rheumatoid arthritis (RA) or GCA during the study period were excluded. The GnP cohort included patients without any RA, GCA or PMR diagnosis codes during the study period, with their ID set as 12 months from the start of continuous health plan enrollment. Patients in both cohorts were required to be age ≥50 years (on ID) with continuous health plan enrollment ≥12 months pre- and post-ID. Cohorts were 1:1 propensity score matched. GC use and incidence of GC-related complications were assessed from GC initiation, starting from the baseline period (12-months pre-ID) through to the end of GC use during the post-index period (i.e. the end of data availability, end of the study period or death [whichever occurred first]). Mean, standard deviation (SD) and median values for continuous variables, and frequency (n and %) for categorical variables were compared between the matched cohorts. Wilcoxon sum rank tests andt-tests on continuous variables and Chi-square tests or Fisher’s exact tests on categorical variables between matched cohorts were conducted. Duration of GC use was analyzed using the Kaplan-Meier method and compared between matched cohorts using log-rank tests.Results:In each of the PMR and GnP cohorts, 16,865 patients were included. In both matched cohorts, median age was 76 years, median Elixhauser comorbidity index score was 2.0, and the majority (~65%) were women. The median follow-up duration was 45 months and 51 months in the PMR and GnP cohorts, respectively. A higher proportion of patients in the PMR cohort than the matched GnP cohort (90.4% vs 62.8%;p<0.001) used GC. The mean (SD) duration of GC therapy was significantly longer in the PMR cohort than in the matched GnP cohort (242.1 [±317.2] days vs 35.5 [±124.6] days;p<0.001). Although patients in the PMR cohort had a lower average daily dose of GC (prednisone equivalent) vs the GnP cohort (mean [SD] mg 16.3 [± 21.9] vs 27.8 [±24.5], respectively [p<0.0001)], the cumulative GC dose was significantly higher in the PMR cohort than the GnP cohort (2125.4 [±3689.5] mg vs 476.6 [±1450.9] mg;p<0.001). This indicates PMR patients used chronic low dose GC while the GnP patients utilized higher dose GC burst therapy less frequently. The number of incident complications associated with GC use were significantly greater in the PMR cohort, and included hypertension, diabetes, skin toxicity, infections, neuropsychiatric effects, endocrine abnormalities, renal dysfunction/ failure, ocular effects, and cardiovascular disease (p<0.05).Conclusion:The overall GC burden in patients with PMR is high. With a higher incidence of GC-related comorbidities among PMR patients, early onset of these complications may be a significant contributor to long-term healthcare costs in these patients.Acknowledgments:This study was funded by Sanofi, Inc. Medical writing, under the direction of authors, was provided by Gauri Saal, MA Economics, Prime, Knutsford, UK, and funded by Sanofi.Disclosure of Interests:Rajeshwari Punekar Shareholder of: Sanofi, Employee of: Sanofi, Patrick LaFontaine Shareholder of: Sanofi, Employee of: Sanofi, John H. Stone Grant/research support from: Roche, Consultant of: Roche

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Outcomes For Hand Burns Treated With Autologous Skin Cell Suspension In 20% Tbsa And Smaller Injuries

Journal of Burn Care & Research ◽

10.1093/jbcr/irab113 ◽

2021 ◽

Author(s):

G Malcolm Taylor ◽

Scott A Barnett ◽

Charles T Tuggle ◽

Jeff E Carter ◽

Herb A Phelan

Keyword(s):

Wound Closure ◽

Exclusion Criterion ◽

Categorical Variables ◽

Dermal Substitute ◽

Continuous Variables ◽

Exact Test ◽

Skin Cell ◽

Returning To Work ◽

Hand Burns ◽

Sheet Graft

Abstract Hypothesis In order to address the confounder of TBSA on burn outcomes, we sought to analyze our experience with the use of autologous skin cell suspensions (ASCS) in a cohort of subjects with hand burns whose TBSA totaled 20% or less. We hypothesized that the use of ASCS in conjunction with 2:1 meshed autograft for the treatment of hand burn injuries would provide comparable outcomes to hand burns treated with sheet or minimally meshed autograft alone. Methods A retrospective review was conducted for all deep partial and full thickness hand burns treated with split thickness autograft (STAG) at our urban verified burn center between April, 2018 to September, 2020. Exclusion criterion was a TBSA greater than 20%. The cohorts were those subjects treated with ASCS in combination with STAG (ASCS(+)) versus those treated with STAG alone (ASCS(-)). All ASCS(+) subjects were treated with 2:1 meshed STAG and ASCS overspray while all ASCS(-) subjects had 1:1, piecrust, or unmeshed sheet graft alone. Outcomes measured included demographics, time to wound closure, proportion returning to work (RTW), and length of time to RTW. Mann-Whitney U test was used for comparisons of continuous variables, and Fishers Exact test for categorical variables. Values are reported as medians and 25 th and 75 th interquartile ranges. Results Fifty-one subjects fit the study criteria (ASCS(+) n=31, ASCS(-) n=20). The ASCS(+) group was significantly older than the ASCS(-) cohort (44 yrs [32, 54] vs 32 [27.5, 37], p=0.009) with larger %TBSA burns (15% [9.5, 17] vs 2% [1, 4], p <0.0001), and larger size hand burns (190 cm2 [120, 349.5] vs 126 cm2 [73.5, 182], p=0.015). Comparable results were seen between ASCS(+) and ASCS(-), respectively, for time to wound closure (9 days [7, 13] vs 11.5 [6.75, 14], p=0.63), proportion RTW (61% vs 70%, p=0.56), and days for RTW among those returning (35 [28.5, 57] vs 33 [20.25, 59], p=0.52). The ASCS(+) group had two graft infections with no reoperations, while ASCS(-) had one infection with one reoperation. No subjects in either group had a dermal substitute placed. Conclusion Despite being significantly older, having larger hand wounds, and larger overall wounds within the parameters of the study criteria, patients with 20% TBSA burns or smaller whose hand burns were treated with 2:1 mesh and ASCS overspray had comparable time to wound closure, proportion of returning to work, and time to return to work as subjects treated with 1:1 or pie-crust meshed STAG. Our group plans to follow this work with scar assessments for a more granular picture of pliability and reconstructive needs.

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Transthyretin cardiac amyloidosis scintigraphy, experience in a reference cardiology center

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeab111.059 ◽

2021 ◽

Vol 22 (Supplement_3) ◽

Author(s):

I Carvajal ◽

E Berrios-Barcenas ◽

E C-Guerra ◽

A Barajas-Paulin ◽

A Luna-Alvarez Amezquita ◽

...

Keyword(s):

Diastolic Dysfunction ◽

Cardiac Amyloidosis ◽

Multimodality Imaging ◽

Categorical Variables ◽

Continuous Variables ◽

Exact Test ◽

Funding Sources ◽

Imaging Characteristics ◽

Septal Thickness ◽

The Face

Abstract Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): Instituto Nacional de Cardiologia Ignacio Chavez Introduction. Transthyretin cardiac amyloidosis (ATTR-CA) is a progressive disease that significantly reduces patients" quality of life and survival.1 In our country there are no statistics of this disease, only isolated cases. The ability to diagnose it has dramatically improved since the 2019 Multisociety Consensus for Multimodality Imaging.2,3 The study aimed to know patients" demographic and imaging characteristics in suspected ATTR-CA and the prevalence of positive cases in a reference Cardiology Center using 99mTc-pyrophosphate scintigraphy (99mTc-PYP). Methods. Prospective, observational study approved by Institutional committees. We studied with 99mTc-PYP patients from November 2019 to December 2020 sent to the Nuclear Cardiology Department with clinical suspicion of ATTR-CA and negative light chain quantification. We included parameters as red flags, ECHO suggestive findings (septal thickness >12 mm, diastolic dysfunction), and MRI suggestive findings. ATTR-CA was diagnosed by clinical suspicious, positive scintigraphy, and negative serum studies. 99mTc-PYP were acquired according to current recommendations. Frequency distribution of categorical variables were reported as frequencies and percentages; continuous variables are presented in mean. Mann-Whitney U tests were conducted for continuous variables, while Fisher"s exact test was performed for categorical variables. Results. Due to the Covid-19 pandemic, our Cardiology Hospital reconverted to covid attention; we studied a reduced number, and they were mainly inpatients: total 35 (28-inpatients, 7-outpatients). 21 (60%) were male, 14 (40%) were female, average age was 56.5 yo. 31%-heart failure diagnosis, 6%-history of carpal tunnel syndrome and 3%-spinal stenosis. ECHO: 26% had suggestive imaging, 43% with diastolic dysfunction, and 37% had a septal thickness >12mm. MRI: 42.9% had suggestive CA findings. No significant differences were found in the characteristics of suspicion between positive and negative patients. Regarding of the 35 patients scintigraphy, 7 (20%) were positives, establishing ATTR-CA diagnosis, 28 (80%) were negatives. The positivity probability was significant by H/Cl ratio, Perugini score, and SPECT findings (p 0.001). Until this protocol started and we share it among hospital physicians, we had never been asked to acquired this type of scintigraphy. Our study shows that if we purposely search for the disease, it can be found. The sample is small due to the limitations we had in the face of the pandemic; however, the study findings are significant for ATTR-CA diagnosis. It is striking that the ECHO and MRI suggestive findings were not statistically significant for the diagnosis. Conclusions. We present the initial experience of the first study of cardiac amyloidosis in our country, to show the disease"s presence and that the diagnosis can be made effectively, quickly, economically, and non-invasively by nuclear medicine scintigraphy.

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Evaluation of the Risk of Clinical Deterioration among Inpatients with COVID-19

Advances in Virology ◽

10.1155/2021/6689669 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Víctor O. Costa ◽

Eveline M. Nicolini ◽

Bruna M. A. da Costa ◽

Fabrício M. Teixeira ◽

Júlia P. Ferreira ◽

...

Keyword(s):

Clinical Laboratory ◽

Lung Parenchyma ◽

Clinical Deterioration ◽

Categorical Variables ◽

Continuous Variables ◽

Chi Square ◽

Exact Test ◽

Laboratory Confirmation ◽

Chi Square Test ◽

Imaging Markers

This study aims to assess the risk of severe forms of COVID-19, based on clinical, laboratory, and imaging markers in patients initially admitted to the ward. This is a retrospective observational study, with data from electronic medical records of inpatients, with laboratory confirmation of COVID-19, between March and September 2020, in a hospital from Juiz de Fora-MG, Brazil. Participants (n = 74) were separated into two groups by clinical evolution: those who remained in the ward and those who progressed to the ICU. Mann–Whitney U test was taken for continuous variables and the chi-square test or Fisher’s exact test for categorical variables. Comparing the proposed groups, lower values of lymphocytes ( p = <0.001) and increases in serum creatinine ( p = 0.009), LDH ( p = 0.057), troponin ( p = 0.018), IL-6 ( p = 0.053), complement C4 ( p = 0.040), and CRP ( p = 0.053) showed significant differences or statistical tendency for clinical deterioration. The average age of the groups was 47.9 ± 16.5 and 66.5 ± 7.3 years ( p = 0.001). Hypertension ( p = 0.064), heart disease ( p = 0.048), and COPD ( p = 0.039) were more linked to ICU admission, as well as the presence of tachypnea on admission ( p = 0.051). Ground-glass involvement >25% of the lung parenchyma or pleural effusion on chest CT showed association with evolution to ICU ( p = 0.027), as well as bilateral opacifications ( p = 0.030) when compared to unilateral ones. Laboratory, clinical, and imaging markers may have significant relation with worse outcomes and the need for intensive treatment, being helpful as predictive factors.

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Internet-Based Flood Detection System (Iot) and Telegram Messenger Using Mcu Node and Water Level Sensor

JOURNAL OF INFORMATICS AND TELECOMMUNICATION ENGINEERING ◽

10.31289/jite.v4i1.3892 ◽

2020 ◽

Vol 4 (1) ◽

pp. 230-235

Author(s):

Novianda Nanda Nanda ◽

Rizalul Akram ◽

Liza Fitria

Keyword(s):

Water Level ◽

Early Warning ◽

High Intensity ◽

Rainy Season ◽

Early Warning System ◽

Detection System ◽

Warning System ◽

Level Sensor ◽

Flood Detection ◽

Internet Of Thing

During the rainy season, several regions in Indonesia experienced floods even to the capital of Indonesia also flooded. Some of the causes are the high intensity of continuous rain, clogged or non-smooth drainage, high tides to accommodate the flow of water from rivers, other causes such as forest destruction, shallow and full of garbage and other causes. Every flood disaster comes, often harming the residents who experience it. The late anticipation from the community and the absence of an early warning system or information that indicates that there will be a flood so that the community is not prepared to face floods that cause a lot of losses. Therefore it is necessary to have a detection system to provide early warning if floods will occur, this is very important to prevent material losses from flooded residents. From this problem the researchers designed an internet-based flood detection System of Things (IoT). This tool can later be controlled via a smartphone remotely and can send messages Telegram messenger to citizens if the detector detects a flood will occur.Keywords: Flooding, Smartphone, Telegram messenger, Internet of Thing (IoT).

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Knowledge of medical students about perioperative nutritional care in Bahia, Brazil: a transversal study

International Journal of Health Education ◽

10.17267/2594-7907ijhe.v5i1.3433 ◽

2021 ◽

Vol 5 (1) ◽

pp. 62-70

Author(s):

Rodrigo Fernandes Weyll Pimentel ◽

Leonardo Castro Dantas Macêdo ◽

Sérgio Diniz Gonçalves Queiroz Filho ◽

Pedro Carlos Muniz de Figueiredo ◽

Magno Conceição das Merces

Keyword(s):

Medical Students ◽

Nutritional Therapy ◽

Cross Sectional Study ◽

Public Institutions ◽

Categorical Variables ◽

Surgical Patient ◽

Continuous Variables ◽

Cross Sectional ◽

Nutritional Care ◽

Exact Test

OBJECTIVE: Evaluate the medical students’ knowledge about perioperative nutritional care. These students are from public and private academic institutions in the state of Bahia, Brazil. METHODS: This is a cross-sectional study to analyze medical students based on an online instrument regarding topics related to perioperative care. For data analysis, absolute and relative frequencies were calculated for categorical variables, and mean and standard deviation were calculated for continuous variables. Fisher's Exact Test and G Test were used to analyze the association. Results: 209 responses were obtained. Regarding the learning on nutritional preparation of the patient submitted to a surgery, 25 (64.9%) students of public institutions and 90 (52.3%) students of private ones reported not knowing or not having been exposed to such knowledge. Regarding the importance of addressing topics related to nutritional therapy (NT), 37 (100%) students from public institutions and 168 (97.7%) from private ones recognize the importance of spreading this knowledge. Unnecessary absolute preoperative fasting, shortening techniques of fasting and bronchoaspiration prevention and reintroduction time of a diet in the postoperative period are unknown to most of the population studied. CONCLUSION: Most students included in this study do not have satisfactory knowledge in NT and for preparing the surgical patient.

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0798 “Uncovering My Feet Alleviates My Restless Legs”: Impact of Different Activities and Conditions on Restless Legs Symptoms

SLEEP ◽

10.1093/sleep/zsaa056.794 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A303-A304

Author(s):

E G Karroum ◽

S Leu-Semenescu ◽

R Amdur ◽

I Arnulf

Keyword(s):

Ambient Temperature ◽

Categorical Variables ◽

Sign Test ◽

Fisher Exact Test ◽

Continuous Variables ◽

Exact Test ◽

Restless Legs ◽

Professional Activities ◽

Wide Range ◽

Activity Condition

Abstract Introduction The restless legs syndrome (RLS) is a resting wake state disorder with inactivity/decreased movement as an aggravating factor and activity/increased movement as an alleviating factor. Other activities and conditions may impact RLS symptoms but have not been systematically studied. Methods Fifty-six patients with primary severe RLS (age: 64.1±11.3; 66% women) responded about the effect of 20 activities/conditions on their RLS symptoms. Responses were assigned a numerical value: Aggravation (-1), No effect/Don’t know (0), Alleviation (+1), with calculating a mean effect score for each activity/condition and using a sign test to determine if that score was significantly above or below zero (no effect). Responses were further analyzed based on age, age at RLS onset, duration of RLS, RLS severity, gender, Familial/Non-familial RLS, and Painful/Non-Painful RLS. Association of continuous variables and categorical variables with each activity/condition was examined using Spearman correlation test and Fisher exact test, respectively. Bonferroni p threshold was set at p=0.00036. Results Activities/conditions with significant (p<0.0001) positive mean effect scores were: Feet uncovering (0.70); Leg massaging (0.63); Cold showers (0.54); and Manual activities (0.46). Activities with significant negative mean effect scores were: Vehicle passenger (-0.80); Show attendance (-0.70); Bedsheets weight on legs (-0.57); Watching TV (-0.54); High ambient temperature (-0.45); During meals (-0.39) (all p<0.0001); and Bedsheets rubbing on legs (-0.34; p=0.0002). Activities/conditions with no significant (all p>0.00036) mean effect scores were: Driving (0.00); Gambling (0.02); Professional activities (0.13); Hot showers (0.13); Using computer (0.14); Low ambient temperature (0.21); Sexual activities (0.27); Mental activities (0.29); and Sports activities (0.34). There was no significant association between each activity/condition and age, age at RLS onset, duration of RLS, RLS severity, gender, Familial/Non-familial RLS, or Painful/Non-Painful RLS. Conclusion There is a wide range of impact of different activities/conditions on RLS symptoms. These could be further considered in the non-pharmacological treatment or prevention of RLS symptoms. Support This study was not funded.

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The Predictive Value of Thromboelastogram in the Evaluation of Patients with Suspected Acute Venous Thromboembolism

Acta Haematologica ◽

10.1159/000502348 ◽

2019 ◽

Vol 143 (3) ◽

pp. 272-278

Author(s):

Tareq Abu Assab ◽

David Raveh-Brawer ◽

Julia Abramowitz ◽

Mira Naamad ◽

Chezi Ganzel

Keyword(s):

Venous Thromboembolism ◽

Emergency Room ◽

Alpha Angle ◽

Categorical Variables ◽

Clot Lysis ◽

Fisher Exact Test ◽

Continuous Variables ◽

Exact Test ◽

Significant Difference ◽

D Dimer

Introduction: The objective of this prospective study was to examine whether thromboelastogram (TEG) can predict the presence of venous thromboembolism (VTE) in patients who arrive at the emergency room with signs/symptoms that raise the suspicion of acute VTE. Methods: Every patient was tested for D-dimer and all TEG parameters, including: reaction time, clot time formation, alpha-angle, maximal amplitude, clot viscoelasticity, coagulation index, and clot lysis at 30 min. For categorical variables, χ2 or the Fisher exact test were used, and for continuous variables the t test or other non-parametric tests were used. Results: During 2016, a total of 109 patients were enrolled with a median age of 55.7 (21–89) years. Eighteen patients were diagnosed with VTE. Analyzing the different TEG parameters, both as continuous and categorical variables, did not reveal a statistically significant difference between VTE-positive and VTE-negative patients. Combining different TEG parameters or dividing the cohort according to gender, clinical suspicion of VTE (Well’s criteria), or different levels of D-dimer did not change the results of the analysis. Conclusion: The current study could not demonstrate a significant value of any TEG parameter as a predictor of VTE among patients who came to the emergency room with signs/symptoms that raise the suspicion of VTE.

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