scholarly journals Salivary profiles of 11-oxygenated androgens follow a diurnal rhythm in patients with congenital adrenal hyperplasia

2021 ◽  
Author(s):  
Hanna Franziska Nowotny ◽  
Matthias K Auer ◽  
Christian Lottspeich ◽  
Heinrich Schmidt ◽  
Ilja Dubinski ◽  
...  
Keyword(s):  
Diurnal Rhythm ◽  
Area Under The Curve ◽  
Early Morning ◽  
Adrenal Hyperplasia ◽  
Treatment Control ◽  
Cross Sectional ◽  
Female Patients ◽  
Single Center Study ◽  
Male Patients ◽  
Monitoring Treatment

Abstract Context Several studies have highlighted the importance of the 11oxygenated 19carbon (11oxC19) adrenalderived steroids as potential biomarkers for monitoring patients with 21hydroxylase deficiency (21OHD). Objective To analyze circadian rhythmicity of 11oxC19 steroids in saliva profiles and evaluate their relevance as potential monitoring parameters in 21OHD. Design, Setting, and Participants Cross-sectional single center study including 59 patients with classic 21OHD (men=30; women=29) and 49 BMI- and agematched controls (men=19; women=30). Outcome Measures Salivary concentrations of the following steroids were analyzed by LCMS/MS: 17hydroxyprogesterone (17OHP), androstenedione (A4), testosterone (T), 11βhydroxyandrostenedione (11OHA4) and 11ketotestosterone (11KT). Results Similar to the previously described rhythmicity of 17OHP, 11OHA4 and 11KT concentrations followed a distinct diurnal rhythm in both patients and controls with highest concentrations in the early morning and declining throughout the day (11-OHA4: mean reduction of hormone concentrations between timepoint one and five (Δmean) in male patients = 66 %; male controls Δmean = 83 %; female patients Δmean = 47 %; female controls Δmean = 86 %; 11KT: male patients Δmean = 57 %; male controls Δmean = 63 %; female patients Δmean = 50 %; female controls Δmean = 76 %). Significant correlations between the area under the curve (AUC) for 17OHP and 11KT (r pmale = 0.773 <0.0001; r pfemale = 0.737 <0.0001), and 11OHA4 (r pmale = 0.633 0.0002; r pfemale = 0.564 0.0014) were observed in patients but not present or reduced in controls. Conclusions Adrenal 11oxC19 androgens are secreted following a diurnal pattern. This should be considered when evaluating their utility for monitoring treatment control.

scholarly journals Salivary profiles of 11-oxygenated androgens follow a diurnal rhythm in patients with congenital adrenal hyperplasia

2021 ◽  
Author(s):  
Hanna Nowotny ◽  
Matthias K. Auer ◽  
Christian Lottspeich ◽  
Heinrich Schmidt ◽  
Ilja Dubinski ◽  
...  
Keyword(s):  
Diurnal Rhythm ◽  
Area Under The Curve ◽  
Early Morning ◽  
Hydroxylase Deficiency ◽  
Cross Sectional ◽  
Female Patients ◽  
Male Patients ◽  
17 Hydroxyprogesterone ◽  
21 Hydroxylase Deficiency ◽  
Monitoring Treatment

AbstractContextSeveral studies have highlighted the importance of the 11-oxygenated 19-carbon (11oxC19) adrenal-derived steroids as potential biomarkers for monitoring patients with 21-hydroxylase deficiency (21OHD).ObjectiveTo analyze circadian rhythmicity of 11oxC19 steroids in saliva profiles and evaluate their relevance as potential monitoring parameters in 21OHD.Design, Setting, and ParticipantsCross-sectional single center study including 34 patients with classic 21OHD (men=14; women=20) and 32 BMI- and age-matched controls (men=15; women=17).Outcome MeasuresSalivary concentrations of the following steroids were analyzed by LC-MS/MS: 17-hydroxyprogesterone (17OHP), androstenedione (A4), testosterone (T), 11β-hydroxyandrostenedione (11OHA4) and 11-ketotestosterone (11KT).ResultsSimilar to the previously described rhythmicity of 17OHP, 11OHA4 and 11KT concentrations followed a distinct diurnal rhythm in both patients and controls with highest concentrations in the early morning and declining throughout the day (11-OHA4: male patients Δmean = 79 %; male controls Δmean = 81%; female patients Δmean = 33 %; female controls Δmean = 91 %; 11KT: male patients Δmean = 64 %; male controls Δmean = 60 %; female patients Δmean = 49 %; female controls Δmean = 81 %). Significant correlations between the area under the curve (AUC) for 17OHP and 11KT (r(p)male = 0.741**; r(p)female = 0.842****), and 11OHA4 (r(p)male = 0.385n.s.; r(p)female = 0.527*) were observed in patients but not in controls.ConclusionsAdrenal 11oxC19 androgens are secreted following a diurnal pattern. This should be considered when evaluating their utility for monitoring treatment control.

scholarly journals Prevalence of Preoperative Anxiety in Preoperative Patients in Nepal Police Hospital: A Cross-sectional Descriptive Study

2021 ◽  
Vol 4 (1) ◽  
pp. 85-88
Author(s):  
Sundar Prasad Hyoju
Keyword(s):  
Descriptive Analysis ◽  
Sampling Technique ◽  
Descriptive Study ◽  
Negative Consequences ◽  
Cardiac Events ◽  
Cross Sectional ◽  
Female Patients ◽  
Pain Ratings ◽  
Male Patients ◽  
Preoperative Patient

Introduction: The possibility of undergoing anesthesia-assisted surgery can cause a great deal of anxiety in individuals. Excessive anxiety can have a number of negative consequences, including perioperative cardiac events, greater anesthetic needs, higher postoperative pain ratings, and a longer stay in the hospital. Anxiety levels during surgery might be influenced by a variety of reasons. The objective of the study was to estimate the prevalence of anxiety in adult patients scheduled for Surgery. Methods: This is Cross-sectional Descriptive Study conducted in Nepal police hospital with calculated sample size of 92 with round figure of 100, convenient sampling technique was used. Descriptive analysis was used for Analysis. Results: Prevalence of anxiety in preoperative patient was 31%. The prevalence in male patients and female patients were 21.2% and 39.5% respectively. Conclusions: When compared to many other research, the general prevalence of anxiety at Nepal Police Hospital was lower; nevertheless, the incidence was higher among female patients.

scholarly journals Diagnostic and prognostic value of plasma adrenomedullin compared to other biomarkers using Sepsis-3 definitions for sepsis and septic shock

2020 ◽  
Author(s):  
Tetsu Yonaha ◽  
Toyoaki Maruta ◽  
Go Otao ◽  
Koji Igarashi ◽  
Sayaka Nagata ◽  
...  
Keyword(s):  
Septic Shock ◽  
Organ Failure ◽  
Sofa Score ◽  
Area Under The Curve ◽  
Final Analysis ◽  
Operating Characteristics ◽  
Diagnosis And Prognosis ◽  
Single Center Study ◽  
Sepsis And Septic Shock ◽  
Monitoring Treatment

Abstract Background Sepsis-3, the recent sepsis definitions, was modified based on a scoring system focused on organ failure; however, it would remain a time-consuming process to detect septic patients using these definitions. Adrenomedullin (AM) is a biomarker for diagnosing sepsis and septic shock, monitoring treatment efficacy, and prognosis. We conducted a study to assess the accuracy of AM for diagnosing and prognosing sepsis and septic shock based on the Sepsis-3 definitions.Methods This is a prospective observational single-center study. Patients admitted to the intensive care unit (ICU) were retrospectively categorized as non-sepsis, sepsis, or septic shock by Sepsis-3 definitions. Total AM (tAM) and mature AM (mAM) were measured upon ICU admission. Receiver operating characteristics (ROC) analyses were performed by calculating the area under the curve (AUC) for diagnosis and prognosis of sepsis and septic shock.ResultsA total of 98 patients were enrolled in the final analysis. Among these, 42, 22, and 34 patients were assigned to non-sepsis, sepsis, and septic shock, respectively. tAM and mAM levels significantly increased according to the severity of sepsis. The AUCs of tAM/mAM for diagnosing sepsis and septic shock were 0.879/0.848 and 0.858/0.830, respectively, whereas those of procalcitonin (PCT)/presepsin (PSEP) were 0.822/0.682 and 0.811/0.661, respectively. The AUCs of tAM/mAM on Day 1 and 3 for predicting 28-day mortality of septic patients were 0.669/0.5741 and 0.931/0.892, respectively, whereas those of sequential organ failure assessment (SOFA) score/lactate were 0.669/0.824 and 0.922/0.794, respectively.Conclusions Both tAM and mAM are reliable, early biomarkers to diagnose sepsis and septic shock according to the Sepsis-3 definitions, and are comparable to PCT. Furthermore, AM level on Day 3 is a reliable biomarker to predict 28-day mortality due to sepsis, which is comparable to that of the SOFA score and lactate level.

scholarly journals Clinical profile of Spondarthritis in females as compared to male patients with reference to HLAB27: A single center study from Nepal

2013 ◽  
Vol 2 (1) ◽  
pp. 3-5 ◽  
Author(s):  
Binit Vaidya ◽  
Shweta Nakarmi ◽  
Pujan Batajoo
Keyword(s):  
Clinical Manifestations ◽  
Spinal Pain ◽  
Clinical Parameters ◽  
Hla B27 ◽  
Clinical Registry ◽  
Cross Sectional ◽  
Early Presentation ◽  
Female Ratio ◽  
Female Patients ◽  
Male Patients

Background and Aims-To study the differences in clinical parameters between male and female patients with spondarthritis (SpA) in Nepalese population; to study the prevalence of HLA B27 phenotype in Nepalese patients with SpA and to study the differences in clinical parameters in relation to HLA B27 phenotype. Methods- This is cross sectional observational study of 102 patients diagnosed with SpA attending rheumatology clinic at Alka Hospital, Nepal from September 2011 to February 2012. Electronic clinical registry was maintained and HLA B27 was performed by flowcytometry. Results- A total of 102 patients with SpA were enrolled in the study with male to female ratio of 1.8:1 . The mean age of male patients was 6±3 years lower than that of female patients (p=0.05). There were no other statistically significant differences in clinical parameters or prevalence of HLA B27 in both the genders. Of the total patients, 52.9% were HLA B27 positive. Presence of HLA B27 was associated with early presentation by 7.1±2.8 years and the occurrence of inflammatory spinal pain P <0.001. Statistically significant association of HLA B27 with other clinical manifestations of SpA were not seen. Conclusions- HLA B27 was present in 52.9% of patients with diagnosed SpA. The presence of HLA B27 was associated with earlier presentation of disease and occurrence of inflammatory spinal pain. However, there was no gender difference in clinical manifestation of SpA or prevalence of HLAB27 in our patients except for early age at presentation in male patients. Journal of Advances in Internal Medicine 2013;02(01):3-5 DOI: http://dx.doi.org/10.3126/jaim.v2i1.7628

scholarly journals Frequency of asthenopia and its association with refractive errors

2015 ◽  
Vol 74 (1) ◽  
Author(s):  
Samuel O. Wajuihian
Keyword(s):  
High School Students ◽  
Primary School Children ◽  
Common Symptom ◽  
Refractive Errors ◽  
School Students ◽  
Cross Sectional ◽  
Female Patients ◽  
School Aged Children ◽  
Male Patients ◽  
And Performance

Background: Asthenopia is a common complaint amongst patients who attend eye care settings. Owing to associated discomfort or distress, asthenopia affects efficient reading and performance of near tasks.Purpose: To study the prevalence of asthenopia and any association with refractive errors in a clinical setting.Methods: In this cross-sectional practice-based study, the clinic records of 1109 school-aged children (mean age and standard deviation 14.39 ± 3.39 years) were analysed. The sample comprised 427 (38.5%) male and 682 (61.5%) female patients between the ages of 6 and 19 years. Refractive errors were classified into various types, and the association between these refractive types and symptoms in asthenopia were explored.Results: The most common symptom of asthenopia was headaches (40.8%), of which temporal headaches were the most frequent type (15.7%). Various symptoms were significantly associated with mainly astigmatism.Conclusion: Headaches were the most frequent complaint amongst patients who attended the author’s optometric practice. Astigmatism was the most frequent cause of asthenopia. Female patients were more likely than male patients to complain of asthenopia, whilst high school students were more likely than primary school children to complain of asthenopia. Further studies to relate asthenopia to binocular anomalies will be relevant in enhancing our understanding of the relationship between asthenopia and vision anomalies.

scholarly journals GAMBARAN KADAR ALBUMINURIA PADA SUBJEK DIABETES MELITUS DENGAN DAN TANPA PENYAKIT JANTUNG KORONER

e-CliniC ◽  
2014 ◽  
Vol 2 (2) ◽  
Author(s):  
Sandy Cendra ◽  
Emma Moeis ◽  
Yuanita Langi
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Renal Physiology ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Female Patients ◽  
Patients With Diabetes ◽  
Male Patients ◽  
Diabetes Melitus

Abstract: Albuminuria is a marker of the decline in renal physiology and function of endothelial. Endothelial dysfunction is an early pathogenesis of coronary heart disease (CHD). High coronary heart disease complications in patients with diabetes mellitus (DM). Objective To know the description and differences in levels of albuminuria in diabetic patients with and without CHD inpoli Metabolic and Endocrine and poli Heart BLU. RSU. Prof. dr. R. D Kandou Manado. Research Method: Cross Sectional descriptive analytic study conducted in patients with diabetes mellitus pieces with and without coronary heart disease in Poli Endocrine Metabolic and poli heart BLU. RSU. Prof. dr. R. D Kandou Manado period November 2012 - November 2013. Results: From 34 patients with diabetes mellitus found the number of diabetic patients with CHD were 17 patients and 17 patients for diabetes without CHD, which consisted of 14 male patients and 20 female patients. The distribution of the sample based on CHD and sex, showed that diabetic patients with CHD were 9 men (26.47%) and 8 women (23.53%). As for diabetic patients without CHD as many as 5 male patients (14.70%) and 12 female patients (35.30%). Distribution of the study sample by CHD and RAKU categories showed diabetic patients with CHD were 7 patients (20.59%) and normal RAKU 10 patients (29.41%) RAKU abnormal. As for diabetic patients without CHD by 16 patients (47.06%) and 1 patient RAKU normal (2.94%) RAKU abnormal. Conclusion: Albuminuria occurs more frequently in patients with diabetes mellitus with coronary heart disease than diabetes mellitus without coronary heart diseaseKeywords: Albuminuria, diabetes mellitus, coronary heart disease.    Abstrak: Albuminuria merupakan petanda terjadinya penurunan faal ginjal dan disfungsi endotel. Disfungsi endotel merupakan patogenesis awal penyakit jantung koroner (PJK). Komplikasi penyakit jantung koroner tinggi pada pasien diabetes melitus (DM). Tujuan: Untuk mengetahui gambaran dan perbedaan kadar albuminuria pada pasien DM dengan dan tanpa PJK di Poli Endokrin Metabolik dan Poli Jantung BLU. RSU. Prof. dr. R. D Kandou  Manado. Metode Penelitian: Dilakukan penelitian deskriptif analitik lintang potong pada penderita diabetes melitus dengan dan tanpa penyakit jantung koroner di Poli Endokrin Metabolik dan Poli Jantung BLU.RSU. Prof. dr. R. D Kandou  Manado periode November 2012 – November 2013. Hasil: Dari 34 pasien Diabetes Melitus ditemukan jumlah pasien DM dengan PJK sebanyak 17 pasien dan 17 pasien untuk DM tanpa PJK, yang terdiri atas 14 orang pasien laki-laki dan 20 pasien wanita. Distribusi sampel berdasarkan PJK dan jenis kelamin, didapatkan hasil pasien DM dengan PJK yaitu sebanyak 9 orang laki-laki (26,47 %) dan 8  orang perempuan (23,53%). Sedangkan untuk pasien DM tanpa PJK yaitu sebanyak 5 orang pasien laki-laki (14,70%) dan 12 orang pasien perempuan (35,30%). Distribusi sampel penelitian berdasarkan PJK dan RAKU Kategori didapatkan hasil pasien DM dengan PJK sebanyak 7 pasien (20,59%) RAKU normal dan 10 pasien (29,41%) RAKU abnormal. Sedangkan untuk pasien DM tanpa PJK sebanyak 16 pasien (47,06%) RAKU normal dan 1 pasien (2,94%) RAKU abnormal. Simpulan: Albuminuria lebih banyak terjadi pada pasien diabetes melitus dengan penyakit jantung koroner dibandingkan diabetes melitus tanpa penyakit jantung koroner Kata kunci: Albuminuria, diabetes melitus, penyakit jantung koroner.

Influence of 5-HTR2C Polymorphisms on Metabolic Syndromes in Thai Schizophrenia Patients

2017 ◽  
Vol 41 (S1) ◽  
pp. S168-S168
Author(s):  
A. Puangpetch ◽  
C. Na Nakorn ◽  
W. Unaharassamee ◽  
C. Sukasem
Keyword(s):  
Metabolic Syndrome ◽  
International Diabetes Federation ◽  
Cross Sectional Study ◽  
Nucleotide Polymorphisms ◽  
Cross Sectional ◽  
Female Patients ◽  
The Metabolic Syndrome ◽  
Significant Difference ◽  
Male Patients ◽  
Competing Interest

IntroductionMetabolic syndrome is a significant problem in the schizophrenia patients. Previous research demonstrated that single nucleotide polymorphisms in the serotonin 2C receptor (5HTR2C) genes are associated with metabolic syndrome related to schizophrenia patients taking atypical anti-psychotic drugs. This study aimed to investigate whether the effect of 3 SNPs in 5HTR2C gene on the presence of the metabolic syndrome in Thai schizophrenia patients.MethodWe conducted a cross-sectional study and 154 patients were recruited. The schizophrenia patients were identified from a diagnostic and statistical manual of mental disorders, 4th edition, (DSM-IV) and criterion and determined the metabolic syndrome according to the 2005 international diabetes federation (IDF) Asia criteria. Patients were genotyped for the 5HTR2C rs51,8147, rs126,881,02, rs128,367,71 polymorphisms.ResultsThe preliminary analysis from 154 patients showed the metabolic syndrome prevalence was 38.73%, with 46.50% in male and 53.48% in female patients. The results showed that the patients who have heterozygous and homozygous variant on 5HTR2C gene (rs518,147 and rs126,881,02) showed a significant difference in the presence of metabolic syndrome when compare with patients who carry homozygous wild type (P = 0.007), especially in male patients (P = 0.002). The association between 5HTR2C polymorphisms and metabolic syndrome was found in male patients but not found in female patients.ConclusionThese findings suggest that 5HTR2C genotypes are associated with the metabolic syndrome in patients taking atypical anti-psychotics. However, the metabolic syndrome results from the multigenetic effects. The further studies should focus on the other genes, which were involved in metabolic syndrome.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Sex-related differences in smear-positive pulmonary tuberculosis patients in Kuala Lumpur, Malaysia: Prevalence and associated factors

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245304
Author(s):  
Norfazilah Ahmad ◽  
Mazni Baharom ◽  
Azimatun Noor Aizuddin ◽  
Rohaya Ramli
Keyword(s):  
Pulmonary Tuberculosis ◽  
Associated Factors ◽  
Multiple Logistic Regression Analysis ◽  
Control Program ◽  
Kuala Lumpur ◽  
Cross Sectional ◽  
Factors Associated ◽  
Female Patients ◽  
Smear Positive Pulmonary Tuberculosis ◽  
Male Patients

Smear-positive pulmonary tuberculosis (PTB) is more infectious compared to smear-negative PTB and have great significance for epidemiology and infection control. The prevalence of smear-positive PTB rarely affects males and females equally. Hence, we aimed to identify the sex-related differences in the prevalence of smear-positive PTB and its associated factors in Kuala Lumpur, Malaysia. A cross-sectional study was conducted using data from the National Tuberculosis Information System (TBIS) from 1 January, 2015, to 31 December, 2019. The study population was selected using simple random sampling from the list of registered PTB patients in TBIS. The criteria for inclusion were all Malaysian adults aged ≥18 years residing in Kuala Lumpur and registered as PTB in TBIS. Factors associated with smear-positive PTB in male and female patients were determined using multiple logistic regression analysis. Overall prevalence of smear-positive PTB was 68.6%, and male patients predominated (71%). The male:female prevalence ratio of smear-positive PTB was 2.4:1. Male patients who worked as machine operators and elementary workers (adjusted odds ratio (aOR) 2.23, 95% confidence interval (CI) 1.24–4.02, p = 0.007), were self-employed (aOR 2.58, 95% CI 1.46–4.56, p = 0.001), lived in a residence categorized as ‘other’ (aOR 2.49, 95% CI 1.28–4.86, p = 0.007) and were smokers (aOR 1.37, 95% CI 1.01–1.87, p = 0.045) had higher odds for smear-positive PTB. Meanwhile, female patients with diabetes mellitus had higher odds for smear-positive PTB (aOR 1.92, 95% CI 1.05–3.54, p = 0.035), while female patients who were healthcare workers had lower odds (aOR 0.33, 95% CI 0.12, 0.94, p = 0.039). The prevalence of smear-positive PTB is higher in males compared to females. The factors associated with smear-positive PTB differed based on sex. The current TB control program, especially on smear-positive PTB, should likely be strategized and stratified by sex.

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