Abstract P243: Inverse Salt Sensitivity In Normotensive Adults: Role Of Demographic Factors

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Nathan T Romberger ◽  
Joseph Stock ◽  
Jordan Patik ◽  
Ron McMillan ◽  
Shannon Lennon ◽  
...  
Keyword(s):  
Test Group ◽  
Urinary Sodium Excretion ◽  
Salt Sensitivity ◽  
Group Differences ◽  
Future Research ◽  
Chi Square ◽  
Exact Test ◽  
High Sodium ◽  
Low Sodium ◽  
Diet Compliance

Inverse salt sensitivity, a sodium induced reduction in blood pressure (BP), has recently been associated with increased incidence of hypertension. However, there is a paucity of data regarding the prevalence of inverse salt sensitivity (ISS). Therefore, the purpose of this retrospective analysis was to determine the prevalence of ISS in a cohort of normotensive adults (n=111; age=37±13yr) and to determine if ISS is associated with any demographic characteristic(s). Subjects included healthy, normotensive, and non-obese adults who participated in a controlled feeding study, consuming a low-sodium (LS, 20 mmol Na/d) and high-sodium (HS, 300 mmol Na/d) diet for 7 days each in a randomized order; diet compliance was assessed with 24-hr urinary sodium excretion (LS=29.0±23.6, HS=240.5±92.0, p<0.0001). On the final day of each diet, 24-hr ambulatory BP was assessed. Subjects were grouped based on change in 24-hr mean arterial pressure (MAP) from the LS to HS diet. ISS was defined as a reduction in MAP >5mmHg, salt sensitive (SS) as an increase in MAP >5mmHg, and salt resistant (SR) as a change in MAP ≤5mmHg. Group differences in sex, age, and BMI were evaluated using Chi Square tests and race using a Fisher’s exact test. Group differences in mean age and BMI were assessed using a one-way ANOVA (mean±SD). Overall (n=111), 12.6% (n=14) were ISS, 72.1% (n=80) SR, and 15.3% (n=17) SS. Prevalence of ISS was not different with respect to sex (male [n=57]: 15.8% (9), female [n=54]: 9.3% (5), p=0.30), race (white [n=84]: 14.3% (12), black [n=16]: 6.3% (1), Asian [n=11]: 9.1% (1), p=0.88), or age (21-40 y.o. [n=64]: 15.6% (10), 41-60 y.o. [n=47]: 8.5% (4), p=0.26). However, prevalence of ISS tended to be higher in those with lower BMI (BMI < 25 [n=71]: 16.9% (12), BMI ≥ 25 [n=40]: 5.0% (2), p=0.07). There were also no group differences with respect to mean age (ISS=34±13yr, SR=37±12yr, SS=41±14yr, p=0.29), but SS had a significantly higher BMI than ISS and SR (ISS=22.9±2.8, SR=24.3±2.6, SS=26.7±3.6, p=0.0009). Together, in a normotensive cohort, we found that 12.6% of subjects were ISS. Furthermore, prevalence of ISS was not different with regards to sex, race, and age, but ISS may be associated with lower BMI. Future research is needed to further understand the ISS phenotype.

scholarly journals Physical Activity, Diet Compliance with Diabetic Ulcer Incidence in Hospital Makassar City

2021 ◽  
Vol 1 (1) ◽  
pp. 36-43
Author(s):  
Nur Yazlim ◽  
Nur Juliana ◽  
Elna Sari ◽  
Rasniah Sarumi
Keyword(s):  
Physical Activity ◽  
Cross Sectional Study ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Dietary Compliance ◽  
Diabetic Ulcer ◽  
Exact Test ◽  
Diabetic Ulcers ◽  
Diet Compliance

Baground: Diabetic foot ulcers are a chronic complication of diabetes in the form of open wounds on the skin surface The prevalence of diabetic foot ulcers in Indonesia is around 13% of patients treated in hospitals and 26% of outpatients. The aimed was to determine relationship between physical activity, dietary compliance with the incidence of diabetic ulcers in Hospital Makassar City. Methods: This type of research used an analytic observational method with a cross sectional study design. Research  were taken by accidental sampling and obtained 78 respondents. Data collection is done by filling out questionnaires. The data were analyzed by chi square fisher's exact test. Results: The results showed that the age of the  with the highest incidence of diabetic ulcers was between 45-60 years was (57,7%) and the lowest was >60 years (42,3%), Women were susceptible to the incidence of diabetic ulcers (62,8%), the highest level of education was high school, namely 50% and the lowest was elementary school ( 1,3%) and employment is dominated by private employees (26,9%) and the lowest is civil servants (11,5%). From 46 respondents with less physical activity (71,8%) rexperienced the incidence of diabetic ulcers, while from 32 respondents in the moderate category (28,2%) experienced diabetic ulcers, p value = 0,019. From 42 respondents in the dietary compliance category, there were (71,8%) experiencing the incidence of diabetic ulcers, from 11 respondents in the diet-adhering category there were (28,2%) experiencing the incidence of diabetic ulcers, obtained a p value of 0,001. Conclusion: There are a significant relationship between physical activity, dietary compliance with the incidence of diabetic ulcers in Hospital Makassar City. Keywords: Diabetic ulcer, physical activity, diet compliance   Abstrak Pendahuluan: Luka kaki diabetik adalah komplikasi kronik diabetes berupa luka terbuka pada permukaan kulit. Prevalensi terjadinya luka kaki diabetes di Indonesia sekitar 13% penderta dirawat di Rumah Sakit dan 26% penderita rawat jalan. Tujuan penelitian untuk mengetahui hubungan aktivitas fisik, kepatuhan diet terhadap kejadian ulkus diabetik di RSUD Kota Makassar. Metode: Jenis penelitian menggunakan metode observasional analitik dengan rancangan cross sectional study. Responden penelitian diambil dengan accidental sampling dan didapat 78 responden. Pengambilan data dilakukan dengan pengisian kuisioner. Data tersebut dianalisis dengan chi square fisher's exact test. Hasil: Hasil penelitian menunjukkan bahwa usia responden dengan kejadian ulkus diabetik tertinggi antara 45-60 tahun (57,7%) dan terendah >60 tahun (42,3%), berdasarkan jenies kelamin wanita rentan terhadap kejadian ulkus diabetik (62,8%), tingkat pendidikan terbanyak SMA yaitu 50% dan terendah SD (1,3%), pekerjaan didominasi oleh pegawai swasta (26,9%) dan terendah PNS (11,5%). Dari 46 responden dengan aktivitas fisik kurang terdapat (71,8%) responden mengalami kejadian ulkus diabetik sedangkan dari 32 responden dengan kategori cukup (28,2%) mengalami kejadian ulkus diabetik nilai p value = 0,019. Dari 42 responden dengan kategori kepatuhan diet, terdapat (71,8%)  mengalami kejadian ulkus diabetik sedangkan dari 11 responden dengan kategori patuh diet terdapat (28,2%) mengalami mengalami kejadian ulkus diabetik,  diperoleh nilai p 0,001 Kesimpulan: Ada hubungan signifikan antara aktivitas fisik, kepatuhan  diet dengan kejadian ulkus diabeti RSUD Kota Makassar. Kata kunci: Ulkus diabetik, aktivitas fisik, kepatuhan diet

Renal nerve effects on renal adaptation to changes in sodium intake during ovine pregnancy

1992 ◽  
Vol 262 (5) ◽  
pp. F823-F829
Author(s):  
G. W. Aberdeen ◽  
S. C. Cha ◽  
S. Mukaddam-Daher ◽  
B. S. Nuwayhid ◽  
E. W. Quillen
Keyword(s):  
Steady State ◽  
Sodium Intake ◽  
Urinary Sodium Excretion ◽  
Renal Nerves ◽  
Renal Nerve ◽  
High Sodium ◽  
Low Sodium ◽  
Pregnant Sheep ◽  
Urinary Potassium ◽  
Renal Nerve Activity

To assess the possibility of an enhanced role of renal nerves in the control of urinary sodium excretion (UNaV) and fluid homeostasis during pregnancy, urine output, UNaV, and urinary potassium excretion were assessed hourly for 3 days before and for 6 days after a step reduction in total daily sodium intake from 400 to 40 mmol. Studies were performed in normal conscious sheep (4 nonpregnant and 4 pregnant). Each animal was prepared with a divided bladder so that urine could be collected simultaneously from one normally innervated and one denervated kidney. In nonpregnant ewes, ratios of the rates of excretion by denervated vs. innervated kidneys for UNaV averaged 1.00 +/- 0.07 under steady-state conditions at high levels of sodium intake. This ratio was not different at the low-sodium-intake state. In contrast, this ratio was 1.15 +/- 0.07 at high sodium intake and 1.13 +/- 0.03 at low sodium intake in pregnant ewes. The ratios at both steady-state intake levels were different (P less than 0.05) between nonpregnant and pregnant sheep. During the transition between sodium intake states, these ratios were unchanged in nonpregnant animals, whereas pregnant animals exhibited peak ratios of 2.20 +/- 0.39 (P less than 0.05), indicating sodium wasting by the denervated kidneys. In summary, the data suggest that renal nerve activity may not be completely suppressed by high sodium intakes in pregnant sheep. Furthermore, the renal nerves have an enhanced influence on sodium conservation during and after the transition from high- to low-sodium-intake states during pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS)

Abstract 025: Urine Angiotensinogen and Salt-Sensitivity of Blood Pressure: The GenSalt Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Casey M Rebholz ◽  
Jing Chen ◽  
Qi Zhao ◽  
Dongfeng Gu ◽  
Jichun Chen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Standard Deviation ◽  
Confidence Interval ◽  
Systolic Blood Pressure ◽  
Salt Sensitivity ◽  
Angiotensin System ◽  
High Sodium ◽  
Low Sodium ◽  
Study Participants ◽  
Urine Levels

Urine excretion of angiotensinogen (AGT) has been proposed as a biomarker of intrarenal renin-angiotensin system activity, and therefore as a proxy for blood pressure regulation and sodium homeostasis. The association between urine levels of AGT and blood pressure response to dietary sodium intake has not been previously examined in the general population. We assessed the hypothesis that there is a direct relationship between urine levels of AGT and salt-sensitivity of blood pressure among participants of the Genetic Epidemiology Network of Salt Sensitivity (GenSalt) replication study. A 7-day low-sodium intervention, followed by a 7-day high-sodium intervention was carried out among 698 GenSalt-replication study participants from rural areas of north China. Absolute urine AGT excretion (μg/24 hours) and AGT-to-creatinine ratio (AGT/Cr, μg/g) were estimated at baseline for a random sample of 100 study participants. Nine blood pressure measurements were obtained at baseline and on the last three days of each intervention period. The absolute and percent changes in mean blood pressure from low-sodium to high-sodium intervention were used to assess salt-sensitivity. Median AGT and AGT/Cr were significantly (both p=0.01) reduced during the low-sodium intervention (AGT: 7.16 μg/24 hours, AGT/Cr: 8.36 μg/g) and increased during the high-sodium intervention (AGT: 8.84 μg/24 hours, AGT/Cr: 10.92 μg/g) compared to baseline (AGT: 8.28 μg/24 hours, AGT/Cr: 9.40 μg/g). Log-transformed AGT and AGT/Cr ratio at baseline was significantly and positively associated with blood pressure at baseline and at the end of each intervention. For example, one standard deviation higher log-transformed AGT/Cr ratio (1.2 μg/g) was associated with a 4.0 mm Hg (95% confidence interval: 1.3, 6.7) higher systolic blood pressure level at the end of the high-sodium intervention (p=0.004). One standard deviation higher log-transformed AGT/Cr ratio was associated with 1.58-times increased odds of high salt-sensitivity (≥5% change) of blood pressure (95% confidence interval: 1.00, 2.50; p=0.049). Log-transformed AGT/Cr ratio at baseline was positively associated with absolute and percent systolic blood pressure change from low- to high-sodium interventions (absolute: r=0.23, p=0.02; percent: r=0.20, p=0.047). In conclusion, elevated levels of urine AGT are associated with sodium-sensitivity of blood pressure. Augmentation of renal-angiotensin system activity may play an important role in the development of salt-sensitive hypertension.

Abstract P234: Genetic Variants of the Kallikrein-kinin System Associated with the Salt Sensitivity of Blood Pressure: The GenSalt Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Dongfeng Gu ◽  
Qi Zhao ◽  
Tanika N Kelly ◽  
James E Hixson ◽  
Dabeeru C Rao ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Genetic Variants ◽  
Dietary Intervention ◽  
Linkage Disequilibrium Block ◽  
Salt Sensitivity ◽  
Dietary Sodium ◽  
Kinin System ◽  
High Sodium ◽  
Low Sodium ◽  
Kallikrein Kinin System

The kallikrein-kinin system (KKS) has been implicated in the pathogenesis of salt-sensitive hypertension in animal models. We comprehensively examined the association between genetic variants of the KKS and blood pressure (BP) response to dietary sodium intervention among participants of the Genetic Epidemiology Network of Salt Sensitivity (GenSalt) study. A 7-day low-sodium dietary intervention followed by a 7-day high-sodium dietary intervention was carried out among 1,906 GenSalt participants from rural areas of north China. Nine BP measurements were obtained at baseline and on the last three days of each intervention period using a random-zero sphygmomanometer. The percentage changes in mean BP from baseline to low-sodium intervention and from low-sodium to high-sodium intervention were used to assess individual salt-sensitivity. A total of 205 tagSNPs and functional SNPs of eleven genes of the KKS ( BDKRB1 , BDKRB2 , CPN1 , CPN2 , CPM , ECE1 , KLK1 , KLKB1 , KNG1 , MME , SERPINA4 ) were selected and genotyped in this study. Single marker analyses were conducted using the Family Based Association Test program. Genetic variants in the bradykinin receptor B2 ( BDKRB2 ) and endothelin converting enzyme 1 ( ECE1 ) genes showed significant associations with salt sensitivity even after adjusting for multiple testing using the false discovery rate method. SNP rs11847625 of BDKRB2 was significantly associated with systolic BP (SBP) response to low-sodium intervention ( P = 0.0001). Compared to its major allele G, carriers of the minor allele C had greater SBP decrease during low-sodium intervention. Furthermore, a haplotype containing allele C was associated with greater SBP increase to high-sodium intervention ( P = 0.0009). Seven SNPs of ECE1 , one of the degrading enzymes of kinins, were significantly associated with diastolic BP (DBP) response to low-sodium intervention ( P values ranged from 0.0003 to 0.002). Two haplotypes in the linkage disequilibrium block including these seven SNPs were significantly associated with DBP response to low-sodium intervention (P=0.0004 and 0.003, respectively). Our study found that the genetic variants of the KKS were associated with salt sensitivity of BP. Replication and functional studies of the identified variants are warranted in the future.

Abstract 093: Salt-sensitivity, Salt-resistance, and Incidence of Hypertension

Hypertension ◽  
2016 ◽  
Vol 68 (suppl_1) ◽  
Author(s):  
Jiang He ◽  
Jing Chen ◽  
Jianfeng Huang ◽  
Jichun Chen ◽  
Hua He ◽  
...  
Keyword(s):  
Latent Class ◽  
Dietary Intervention ◽  
Salt Resistance ◽  
Salt Sensitivity ◽  
Latent Class Models ◽  
Dietary Sodium ◽  
Incident Hypertension ◽  
High Sodium ◽  
Low Sodium ◽  
Increased Risk

It is well known that blood pressure (BP) responses to dietary sodium intake vary among individuals (salt-sensitivity and salt-resistance). However, it is unknown whether salt-sensitivity and salt-resistance predict the risk of hypertension. We conducted a dietary sodium intervention study among 1,906 Han Chinese in 2003-05 and followed the study participants in 2008-09 and 2011-12. The dietary intervention included a 7-day low-sodium feeding (51.3 mmol/day) and a 7-day high-sodium feeding (307.8 mmol/day). Three BP measurements were obtained during each of the 3 days of baseline observation and on days 5, 6, and 7 of each intervention period. We used latent class models to identify subgroups that share a similar underlying trajectory in BP responses to sodium intervention. Over an average of 7.4 years of follow-up, we identified 514 incident hypertension cases. The mean (standard deviation) change in systolic BP during low-sodium and high-sodium interventions according to salt-sensitive and -resistant groups are shown in the following table. In addition, age, sex, and baseline BP-adjusted and multiple-adjusted odds ratios (95% CI) of incident hypertension are shown in the following table. These data indicate that high responses or non-responses to dietary sodium intervention are related to the risk of hypertension. Furthermore, this is the first prospective cohort study to indicate that individuals with either salt-sensitivity or salt-resistance are at an increased risk for hypertension and should be targeted for dietary intervention.

Abstract P232: Common Variants of the Estrogen Receptor 1 Gene Predict Decreased Blood Pressure Salt-Sensitivity in Men: The GenSalt Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Tanika N Kelly ◽  
Casey M Rebholz ◽  
Dongfeng Gu ◽  
James E Hixson ◽  
Dabeeru C Rao ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Estrogen Receptor ◽  
Sex Hormones ◽  
Heart Association ◽  
Complex Trait ◽  
Salt Sensitivity ◽  
Nucleotide Polymorphisms ◽  
High Sodium ◽  
Low Sodium ◽  
Estrogen Receptor 1

Previous reports have documented increased blood pressure (BP) salt-sensitivity in women compared to men, suggesting that genes encoding sex hormones could influence BP response to sodium. In the current study, we examined the association between 799 single nucleotide polymorphisms (SNPs) in 44 genes involved in sex hormone biosynthesis, bioavailability and metabolism for their association with BP responses to sodium intervention separately in men and women. A 7-day low-sodium (51.3 mmol sodium/day) followed by a 7-day high-sodium feeding-study (307.8 mmol sodium/day) was conducted among 1,906 participants from 633 Han Chinese families. Nine BP measurements were obtained at baseline and the end of each intervention period using a random-zero sphygmomanometer. Additive associations between each SNP and BP responses to low and high-sodium interventions were assessed using a mixed linear regression model to account for familial dependencies. Among men, absolute BP responses to sodium interventions decreased with the number of minor alleles of estrogen receptor 1 (ESR1) markers rs9340844, rs9397453 and rs9383951. For example, men with genotypes C/C, C/T, and T/T of rs9397453 had respective mean DBP responses [95% confidence intervals (CI)] of: -2.67 (-3.13, -2.22), -1.23 (-1.98, -0.48), and 0.08 (-2.31, 2.47) mmHg to low-sodium intervention [p=1×10 -4 ; false discovery rate (FDR)-q=0.04]; and 1.46 (1.03, 1.89), 0.19 (-0.54, 0.91), and -1.10 (-2.82, 0.61) mmHg to high-sodium intervention (p=2×10 -4 ; FDR-q=0.04). In addition, mean SBP responses (95% CI) were: -5.70 (-6.19, -5.20), -4.34 (-5.37, -3.31), and -2.65 (-5.15, -0.16) mmHg, respectively, for low-sodium intervention (p=2×10 -3 ; FDR-q=0.17); and 4.56 (4.12, 4.99), 3.47 (2.63, 4.30), and 1.97 (-0.49, 4.43) mmHg, respectively, for high-sodium intervention (p=3×10 -3 ; FDR-q=0.40). ESR1 variants were not associated with BP responses in women, with highly significant genotype-gender interactions noted. In summary, we identified strong, consistent associations between genetic variants in the ESR1 gene and decreased salt-sensitivity in men. Although replication of these findings is needed, our results support a role for sex-hormones in the etiology of this complex trait. Funding(This research has received full or partial funding support from the American Heart Association, National Center)

Neurogenic regulation of rate of achieving sodium balance after increasing sodium intake

1991 ◽  
Vol 261 (2) ◽  
pp. F300-F307 ◽  
Author(s):  
S. G. Greenberg ◽  
S. Tershner ◽  
J. L. Osborn
Keyword(s):  
Sodium Intake ◽  
Plasma Renin ◽  
Sympathetic Nerves ◽  
Urinary Sodium Excretion ◽  
Significant Inhibition ◽  
Sodium Balance ◽  
Renal Nerves ◽  
High Sodium ◽  
Low Sodium ◽  
Renal Tubular

Evidence that the renal sympathetic nerves have direct effects on renal tubular function suggests that neurogenic mechanisms may play an important role in the daily regulation of sodium balance. We evaluated the influence of the renal nerves on the rate of elevating urinary sodium excretion (UNaV) after a step increase in fixed sodium intake. Conscious rats with innervated (INN) or denervated (DNX) kidneys were placed on low-sodium intake (LNa = 0.3 meq/day) or a normal sodium intake (NNa = 1.0 meq/day) by intravenous infusion. Hourly changes in UNaV were determined 24 h before and 72 h after increasing sodium intake to either NNa or high-sodium intake (HNa = 5.0 meq/day). Switching from LNa to NNa, INN rats increased UNaV within 24 h; however, DNX rats did not begin to increase UNaV until hour 60. Cumulative sodium balance over 72 h was more positive in DNX rats (INN = 1.29 +/- 0.29 meq; DNX = 2.06 +/- 0.21 meq, P less than 0.05). During the LNa-to-HNa switch, both INN and DNX rats increased UNaV equally for 12 h; however, at this time INN rats continued to increase UNaV, whereas DNX rats did not. DNX rats had a net accumulation of 2.54 meq more sodium than INN rats over 72 h. Significant inhibition of plasma renin activity within the first 24 h occurred only in rats receiving the LNa-to-HNa switch in sodium intake, and this response was not different between rats with innervated and denervated kidneys. These data suggest that the renal nerves provide a rapid sodium excretory response to step increases in sodium intake.(ABSTRACT TRUNCATED AT 250 WORDS)

Venous Thromboembolism and High Grade Gliomas

1993 ◽  
Vol 70 (03) ◽  
pp. 393-396 ◽  
Author(s):  
Mandeep S Dhami ◽  
Robert D Bona ◽  
John A Calogero ◽  
Richard M Hellman
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Medical Center ◽  
Significant Risk ◽  
Bleeding Complications ◽  
Fisher Exact Test ◽  
High Grade ◽  
Chi Square ◽  
Exact Test ◽  
High Grade Gliomas

SummaryA retrospective study was done to determine the incidence of and the risk factors predisposing to clinical venous thromboembolism (VTE) in patients treated for high grade gliomas. Medical records of 68 consecutive patients diagnosed and treated at Saint Francis Hospital and Medical Center from January 1986 to June 1991 were reviewed. The follow up was to time of death or at least 6 months (up to December 1991). All clinically suspected episodes of VTE were confirmed by objective tests. Sixteen episodes of VTE were detected in 13 patients for an overall episode rate of 23.5%. Administration of chemotherapy (p = 0.027, two tailed Fisher exact test) and presence of paresis (p = 0.031, two tailed Fisher exact test) were statistically significant risk factors for the development of VTE. Thrombotic events were more likely to occur in the paretic limb and this difference was statistically significant (p = 0.00049, chi square test, with Yates correction). No major bleeding complications were seen in the nine episodes treated with long term anticoagulation.We conclude that venous thromboembolic complications are frequently encountered in patients being treated for high grade gliomas and the presence of paresis and the administration of chemotherapy increases the risk of such complications.

Use of SAMe-TT₂R₂ Score to Predict the Quality of Anticoagulation Control in Patients with Atrial Fibrillation Receiving Warfarin in Thailand

2020 ◽  
Vol 103 (6) ◽  
pp. 548-552
Keyword(s):  
Atrial Fibrillation ◽  
Therapeutic Range ◽  
Statistical Significance ◽  
Discrimination Performance ◽  
Poor Quality ◽  
Chi Square ◽  
Exact Test ◽  
Time In Therapeutic Range ◽  
Anticoagulation Control

Objective: To predict the quality of anticoagulation control in patients with atrial fibrillation (AF) receiving warfarin in Thailand. Materials and Methods: The present study retrospectively recruited Thai AF patients receiving warfarin for three months or longer between June 2012 and December 2017 in Central Chest Institute of Thailand. The patients were classified into those with SAMe-TT₂R₂ of 2 or less, and 3 or more. The Chi-square test or Fisher’s exact test was used to compare the proportion of the patients with poor time in therapeutic range (TTR) between the two groups of SAMe-TT₂R₂ score. The discrimination performance of SAMe-TT₂R₂ score was demonstrated with c-statistics. Results: Ninety AF patients were enrolled. An average age was 69.89±10.04 years. Most patients were persistent AF. An average CHA₂DS₂-VASc, SAMe-TT₂R₂, and HAS-BLED score were 3.68±1.51, 3.26±0.88, and 1.98±0.85, respectively. The present study showed the increased proportion of AF patients with poor TTR with higher SAMe-TT₂R₂ score. The AF patients with SAMe-TT₂R₂ score of 3 or more had a larger proportion of patients with poor TTR than those with SAMe-TT₂R₂ score of 2 or less with statistical significance when TTR was below 70% (p=0.03) and 65% (p=0.04), respectively. The discrimination performance of SAMe-TT₂R₂ score was demonstrated with c-statistics of 0.60, 0.59, and 0.55 when TTR was below 70%, 65% and 60%, respectively. Conclusion: Thai AF patients receiving warfarin had a larger proportion of patients with poor TTR when the SAMe-TT₂R₂ score was higher. The score of 3 or more could predict poor quality of anticoagulation control in those patients. Keywords: Time in therapeutic range, Poor quality of anticoagulation control, Warfarin, SAMe-TT₂R₂, Labile INR

PREEMPTIVE ANALGESIA WITH AMITRIPTYLINE IN WOMEN UNDERGOING ABDOMINAL HYSTERECTOMY: A RANDOMIZED CLINICAL TRIAL

2020 ◽  
pp. 2-5
Author(s):  
Antônio Henriques De França Neto ◽  
Alexandre Magno Nóbrega Marinho ◽  
Eveline Pereira De Arruda Agra ◽  
Priscilla Guimarães Alves ◽  
Josikwylkson Costa Brito ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Postoperative Pain ◽  
Pressure Pain Threshold ◽  
Abdominal Hysterectomy ◽  
Tricyclic Antidepressant ◽  
Preemptive Analgesia ◽  
Chi Square ◽  
Double Blind ◽  
Exact Test ◽  
Student’S T

The concept of preemptive analgesia, albeit long-standing, has reemerged. Consequently, recent research has focused on testing a variety of drugs preoperatively to prevent the occurrence of postoperative pain, a major factor of morbidity. Amitriptyline is a tricyclic antidepressant used to treat chronic pain. Because amitriptyline acts on pain transmission pathways, it could theoretically be used as an agent for the prevention of postoperative pain. This study evaluated the effectiveness of amitriptyline in preventing pain in patients submitted to hysterectomy, the most commonly performed gynecological surgery. A randomized, double-blind clinical trial was conducted with 145 patients, 72 of these receiving amitriptyline and 73 placebo. All patients were evaluated at 6, 12, 24 and 48 hours after surgery using a visual analog scale (VAS) for pain and algometry to determine the pressure-pain threshold. Statistical analysis was conducted using the chi-square test of association, Student's t-test, and the Mann-Whitney test, with Fisher's exact test being used whenever appropriate. No statistically signicant difference was found between the two groups with respect to pain at any of the time points evaluated, leading to the conclusion that at a dose of 25 mg, amitriptyline is ineffective in preventing postoperative pain in patients submitted to abdominal hysterectomy

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