Does Perioperative Hemoglobin A1c Level Affect the Incidence, Pattern and Mortality of Lower Extremity Amputation?

2019 ◽  
Vol 17 (4) ◽  
pp. 354-364
Author(s):  
Hassan Al-Thani ◽  
Moamena El-Matbouly ◽  
Maryam Al-Sulaiti ◽  
Noora Al-Thani ◽  
Mohammad Asim ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Lower Extremity ◽  
Hazard Ratio ◽  
Lower Extremity Amputation ◽  
Group 4 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Extremity Amputation ◽  
Group 1

Background: We hypothesized that perioperative HbA1c influenced the pattern and outcomes of Lower Extremity Amputation (LEA). Methods: A retrospective analysis was conducted for all patients who underwent LEA between 2000 and 2013. Patients were categorized into 5 groups according to their perioperative HbA1c values [Group 1 (<6.5%), Group 2 (6.5-7.4%), Group 3 (7.5-8.4%), Group 4 (8.5-9.4%) and Group 5 (≥9.5%)]. We identified 848 patients with LEA; perioperative HbA1c levels were available in 547 cases (Group 1: 18.8%, Group 2: 17.7%, Group 3: 15.0%, Group 4: 13.5% and Group 5: 34.9%). Major amputation was performed in 35%, 32%, 22%, 10.8% and 13.6%, respectively. Results: The overall mortality was 36.5%; of that one quarter occurred during the index hospitalization. Mortality was higher in Group 1 (57.4%) compared with Groups 2-5 (46.9%, 38.3%, 36.1% and 31.2%, respectively, p=0.001). Cox regression analysis showed that poor glycemic control (Group 4 and 5) had lower risk of mortality post-LEA [hazard ratio 0.57 (95% CI 0.35-0.93) and hazard ratio 0.46 (95% CI 0.31-0.69)]; this mortality risk persisted even after adjustment for age and sex but was statistically insignificant. The rate of LEA was greater among poor glycemic control patients; however, the mortality was higher among patients with tight control. Conclusion: The effects of HbA1c on the immediate and long-term LEA outcomes and its therapeutic implications need further investigation.

scholarly journals Association between serum oestradiol level on the hCG administration day and neonatal birthweight after IVF-ET among 3659 singleton live births

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yu Liu ◽  
Jing Li ◽  
Wanyu Zhang ◽  
Yihong Guo
Keyword(s):  
Birth Weight ◽  
Ovarian Stimulation ◽  
Group 4 ◽  
Group 6 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
The Impact ◽  
Ivf Et ◽  
Group 1

AbstractOestradiol, an important hormone in follicular development and endometrial receptivity, is closely related to clinical outcomes of fresh in vitro fertilization-embryo transfer (IVF-ET) cycles. A supraphysiologic E2 level is inevitable during controlled ovarian hyper-stimulation (COH), and its effect on the outcome of IVF-ET is controversial. The aim of this retrospective study is to evaluate the association between elevated serum oestradiol (E2) levels on the day of human chorionic gonadotrophin (hCG) administration and neonatal birthweight after IVF-ET cycles. The data of 3659 infertile patients with fresh IVF-ET cycles were analysed retrospectively between August 2009 and February 2017 in First Hospital of Zhengzhou University. Patients were categorized by serum E2 levels on the day of hCG administration into six groups: group 1 (serum E2 levels ≤ 1000 pg/mL, n = 230), group 2 (serum E2 levels between 1001 and 2000 pg/mL, n = 524), group 3 (serum E2 levels between 2001 and 3000 pg/mL, n = 783), group 4 (serum E2 levels between 3001 and 4000 pg/mL, n = 721), group 5 (serum E2 levels between 4001 and 5000 pg/mL, n = 548 ), and group 6 (serum E2 levels > 5000 pg/mL, n = 852). Univariate linear regression was used to evaluate the independent correlation between each factor and outcome index. Multiple logistic regression was used to adjust for confounding factors. The LBW rates were as follows: 3.0% (group 1), 2.9% (group 2), 1.9% (group 3), 2.9% (group 4), 2.9% (group 5), and 2.0% (group 6) (P = 0.629), respectively. There were no statistically significant differences in the incidences of neonatal LBW among the six groups. We did not detect an association between peak serum E2 level during ovarian stimulation and neonatal birthweight after IVF-ET. The results of this retrospective cohort study showed that serum E2 peak levels during ovarian stimulation were not associated with birth weight during IVF cycles. In addition, no association was found between higher E2 levels and increased LBW risk. Our observations suggest that the hyper-oestrogenic milieu during COS does not seem to have adverse effects on the birthweight of offspring after IVF. Although this study provides some reference, the obstetric-related factors were not included due to historical reasons. The impact of the high estrogen environment during COS on the birth weight of IVF offspring still needs future research.

Timing of melatonin treatment: differential effects on oestrus and coat growth in goats

1997 ◽  
Vol 65 (2) ◽  
pp. 267-273 ◽  
Author(s):  
I. A. Forsyth ◽  
F. E. Gebbie ◽  
J. Arendt
Keyword(s):  
Goat Milk ◽  
Normal Weight ◽  
Ovarian Activity ◽  
Plasma Prolactin ◽  
Dairy Goats ◽  
Group 4 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

AbstractTo avoid winter scarcity of fresh goat milk, simple methods of advancing the season of kidding would be commercially valuable. A combination of long-day light treatment followed by melatonin is successful but other aspects of seasonality including coat growth are also reset. To investigate whether effects on breeding season and coat growth can be dissociated, British Saanen dairy goats (no. = 30) were randomly allocated to one of six groups. Control goats were untreated. Goats in the other five groups received 2 months of treatment with 20 h light: 4 h darkness (20L: 4D) and were then given 3 mg melatonin orally at 16.00 hfor 2 months. The treatments started on 11 January (group 1), 29 March (group 2), 14 June (group 3), 30 August (group 4) and 8 November (group 5). Weekly blood samples were taken for the measurement of progesterone to monitor ovarian activity and prolactin. Side patches (10 cm ×10 cm) were clipped monthly from alternate sides and weighed to measure coat growth. The onset of ovarian activity was advanced from a median date of 15 November in controls to 24 May in group 1 (P < 0·01), 16 August in group 2 (P < 0·05) and 18 October in group 3 (? < 0·05). Groups 4 and 5 showed no significant change in the onset of oestrus (median onset dates 8 November and 1 November, respectively). Group 1 goats came into season again with controls in November. In all except group 5, treatment interacted with time to affect significantly the growth of the coat. The pattern of coat growth was most altered (P < 0·001) in groups 1 and 2. This was associated with effects on plasma prolactin concentrations of light stimulation and melatonin suppression. Group 1 goats resynchronized with control goats to show a coat of normal weight in the winter following treatment. Division of milking goat herds into spring and autumn kidding groups is, therefore, a practical possibility, but effects on overall milk yield require study.

THE EFFECTS OF SLAUGHTER WEIGHT AND SEX ON THE COOKING LOSSES FROM AND PALATABILITY ATTRIBUTES OF PORK LOIN CHOPS

1984 ◽  
Vol 64 (1) ◽  
pp. 39-43 ◽  
Author(s):  
L. E. JEREMIAH ◽  
G. M. WEISS
Keyword(s):  
Key Words ◽  
Slaughter Weight ◽  
Cooking Properties ◽  
Group 4 ◽  
Practical Standpoint ◽  
Group 3 ◽  
Pork Loin ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

A total of 130 barrows and 113 gilts were slaughtered over a range of liveweights from 65.6 to 143.9 kg. These animals were randomly assigned to six different liveweight groups (group 1, less than 79.5 kg; group 2, 79.5 through 93.1 kg; group 3, 93.2 through 106.7 kg; group 4, 106.8 through 120.4 kg; group 5, 120.5 through 134.0 kg; and group 6, 134.1 kg and over) and utilized to evaluate the effects of slaughter weight and sex on palatability and cooking properties. The composite results indicated that the slaughter weight of both barrows and gilts can, from a practical standpoint, be increased to take advantage of potential economic advantages without meaningfully altering cooking losses or palatability attributes. Key words: Pork, slaughter weight, sex, palatability, cooking losses

scholarly journals Zingerone Ameliorates Hepatotoxicity

2020 ◽  
Vol 11 (1) ◽  
pp. 280-284 ◽  
Author(s):  
Julietpoornamathy J ◽  
Parameswari C.S.
Keyword(s):  
The Body ◽  
Control Group ◽  
Medical Sciences ◽  
Toxic Compounds ◽  
Group 4 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Insight Into ◽  
Group 1

In medical sciences, toxicity is an area wherein extensive studies have been carried to improve the diseases as well as to prevent. So, there is a high requirement for novel and improved alternative therapeutic strategies to manage diseases. The liver is the largest gland in the body, which executes several important mechanisms; it stores minerals and vitamins and releases them in periods of need. The main aim of this study was to give a closer insight into potent non- toxic compounds that is capable of modifying the responses. Animals were divided into five equal groups viz control (Group 1), administered with food and water ad libitum, (Group 2) administered with olive oil, (Group 3) administered with zingerone, (Group 4) administered with concanavalin A, (Group 5) administered with cyclosporine A followed by zingerone. Our results revealed significant changes in liver marker enzymes and liver histology of zingerone treated rats when compared to control rats.  A corollary, zingerone has no toxic effect on hepatocytes and was found to be safe at a dose of 10mg/kg b wt and also ameliorates hepatotoxicity.

NMO-IgG and Devic's neuromyelitis optica: a French experience

2008 ◽  
Vol 14 (4) ◽  
pp. 440-445 ◽  
Author(s):  
Romain Marignier ◽  
Jérôme De Sèze ◽  
Sandra Vukusic ◽  
Françoise Durand-Dubief ◽  
Hélène Zéphir ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Staining Pattern ◽  
Transverse Myelitis ◽  
Group 4 ◽  
Acute Transverse Myelitis ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Devic’S Neuromyelitis Optica ◽  
Group 1

Background A serum autoantibody biomarker, NMO-IgG has been recently described in patients with Devic's neuromyelitis optica (DNMO) and so called `high-risk' patients for this disease. Our objectives were to replicate the test and to assess its usefulness. Methods Indirect immunofluorescence with a substrate of adult rat cerebellum and midbrain was used to identify the distinctive NMO-IgG staining pattern. We tested masked sera from 26 patients with DNMO (group 1), 21 patients with idiopathic acute transverse myelitis (ATM) (group 2), 21 patients with bilateral and/or recurrent idiopathic optic neuritis (group 3), 52 patients with classical multiple sclerosis (MS) (group 4), 36 patients with HTLV-1 infection (group 5) and 7 patients with miscellaneous disorders (group 6). Results We identified a vascular staining pattern typical of NMO-IgG. This particular staining was observed in 14/26 samples in group 1, 7/21 in group 2 (positive only in longitudinally extensive acute transverse myelitis: 7/13), 4/21 in group 3 (with bilateral loss of vision in all seropositive cases), 5/52 in group 4 (none of them suggestive of DNMO), 0/36 in group 5 and 0/7 in group 6. Sensitivity of the test was 54% considering detection of DNMO (group 1), and specificity was respectively 94% and 90% when considering groups 4, 5 and 6 altogether or group 4 of MS patients only. Conclusion Detection of NMO-IgG is contributory to the distinction of DNMO and `DNMO high-risk' syndromes from MS. This test may allow earlier diagnosis and help therapeutic decisions. Multiple Sclerosis 2008; 14: 440—445. http://msj.sagepub.com

scholarly journals Low Dose X-Ray Sources and High Quantum Efficiency Sensors: The Next Challenge in Dental Digital Imaging?

2014 ◽  
Vol 2014 ◽  
pp. 1-7
Author(s):  
Arnav R. Mistry ◽  
Daniel Uzbelger Feldman ◽  
Jie Yang ◽  
Eric Ryterski
Keyword(s):  
Low Dose ◽  
Image Resolution ◽  
X Ray ◽  
Imaging Technologies ◽  
Group 4 ◽  
X Ray Imaging ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

Objective(s). The major challenge encountered to decrease the milliamperes (mA) level in X-ray imaging systems is the quantum noise phenomena. This investigation evaluated dose exposure and image resolution of a low dose X-ray imaging (LDXI) prototype comprising a low mA X-ray source and a novel microlens-based sensor relative to current imaging technologies.Study Design. A LDXI in static (group 1) and dynamic (group 2) modes was compared to medical fluoroscopy (group 3), digital intraoral radiography (group 4), and CBCT scan (group 5) using a dental phantom.Results. The Mann-Whitney test showed no statistical significance(α=0.01)in dose exposure between groups 1 and 3 and 1 and 4 and timing exposure (seconds) between groups 1 and 5 and 2 and 3. Image resolution test showed group 1 > group 4 > group 2 > group 3 > group 5.Conclusions. The LDXI proved the concept for obtaining a high definition image resolution for static and dynamic radiography at lower or similar dose exposure and smaller pixel size, respectively, when compared to current imaging technologies. Lower mA at the X-ray source and high QE at the detector level principles with microlens could be applied to current imaging technologies to considerably reduce dose exposure without compromising image resolution in the near future.

Inhibition of protein synthesis does not block myocardial protection afforded by preconditioning

1990 ◽  
Vol 259 (6) ◽  
pp. H1822-H1825 ◽  
Author(s):  
J. Thornton ◽  
S. Striplin ◽  
G. S. Liu ◽  
A. Swafford ◽  
A. W. Stanley ◽  
...  
Keyword(s):  
Protein Synthesis ◽  
Coronary Occlusion ◽  
Actinomycin D ◽  
Protein Synthesis Inhibitors ◽  
Group 4 ◽  
Ischemic Period ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

It is currently unknown how preconditioning the heart with brief periods of ischemia makes it resistant to infarction from a subsequent ischemic insult. The protein synthesis inhibitors, cycloheximide and actinomycin D, were used to determine whether preconditioning involves synthesis of a protective protein. Ischemia was produced by occlusion of a branch of the left coronary artery in open-chest anesthetized rabbits. All groups were subjected to 30 min of ischemia followed by 3 h of reperfusion. The first two groups served as noninhibited controls. Group 1 was subjected to ischemia with no preconditioning. Group 2 was preconditioned with two 5-min ischemic periods each followed by 10 min of reperfusion, before the 30-min ischemic period. Groups 3 and 4 were the same as groups 1 and 2, respectively, except that cycloheximide was administered before coronary occlusion. Groups 5 and 6 were also the same as groups 1 and 2 except that actinomycin D was administered before coronary occlusion. After 3 h of reperfusion all hearts were removed and the size of the ischemic zone and infarct were determined. The percent of the ischemic zone infarcted was small and similar in all preconditioned groups (3.3 +/- 1.1% for group 2, 7.4 +/- 3.3% for group 4, and 0.5 +/- 0.7% for group 6). All nonpreconditioned groups had large infarcts with no differences between groups (39.0 +/- 8.5% for group 1, 31.6 +/- 6.3% for group 3, 30.8 +/- 5.9% for group 5). Because neither cycloheximide nor actinomycin D could block protection afforded by preconditioning, it seems unlikely that synthesis of a protective protein is the mechanism of protection.

A Dosing Study of Nonoxynol-9 and Genital Irritation

1993 ◽  
Vol 4 (3) ◽  
pp. 165-170 ◽  
Author(s):  
R E Roddy ◽  
M Cordero ◽  
C Cordero ◽  
J A Fortney
Keyword(s):  
Significant Problem ◽  
Vaginal Suppository ◽  
Group 4 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Epithelial Disruption ◽  
Symptoms And Signs ◽  
Group 1

The objective of the study was to assess the symptoms and signs of genital irritation produced by different frequencies of nonoxynol-9 (N-9) use. Thirty-five women were randomized to each of 5 groups and used a vaginal suppository for 2 weeks. Group 1: N-9 once every other day; Group 2: N-9 once a day; Group 3: N-9 twice a day; Group 4: N-9 4 times a day; and Group 5: placebo 4 times a day. Study women were examined at admission, one week and 2 weeks with a colposcope for erythema and epithelial disruption, and were interviewed about vaginal itching and burning. The rates of reported symptoms for N-9 users were not significantly different from that of placebo users. The rate of epithelial disruption for women using N-9 every other day was essentially the same as that of women using placebo. The rates of epithelial disruption for women using N-91/day and 2/day were 2.5 times greater than that of placebo users. The rate of epithelial disruption for women using N-9 4/day was five times greater than that of placebo users. Genital irritation was located primarily on the vagina or cervix, and vulvitis was not a significant problem. Women who infrequently use N-9 products may not experience an increase in genital irritation. Women who choose to use N-9 frequently may experience an increase in epithelial disruption.

EFFECT OF TREATMENT WITH STREPTOKINASE AND HEPARIN ON FIBRINOGEN, FIBRIN AND RELATED PROTEINS IN ACUIE MYOCARDIAL INFARCTION (/ME) PATIENTS

1987 ◽  
Author(s):  
V Vila ◽  
E Reganon ◽  
J Aznar ◽  
V Lacueva ◽  
M Ruano
Keyword(s):  
Degradation Products ◽  
Heparin Therapy ◽  
Heparin Group ◽  
Normal Value ◽  
Group 4 ◽  
Group 6 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

The properties of fibrinogen and fibrin, the levels of fibrincpeptide A (FPA) and fibrin(ogen) degradation products (FDP) were studied in 34 patients with AMI who were undergoing thrombolytic and heparin therapy. They were classified into 6 groups accordingto their stage of treatment: group 1, before intravenous administration of 800.000 U streptokinase over 30 min; group 2, after a<Mnistraticn of SK but before adninistraticn of heparin; group 3, during 24 h ofthe 5 ng/h heparin continuous infusion; group 4, during 48-72 h of the 16.6 ng/h heparin continuous infhsion; group 5, after 1 week of administration of SK and with a bolus inyection of 50 rg heparin every 4 h; group 6, patients who were undergoing only heparin treatment. The Fg 1/ Fg II ratio varies during treatment with SK and heparin. In group 1 a sligjnt increase (2.5) is observed. Group 2 shows a significantdecrease (0.6) as a result of fibrinolysis. In group3 the ratio reaches normal value (1.8) while in the fourth group it is twice the normal value (4). The value for group 5 is nearly normal (2.1), and in group 6 it reaches values similar to those obtained in group 4, which implies that the rise in the Fgl/Fgll ratio is not a result of fibrinolytic treatment. TheFPA level shows and increase in patients with AMI (group 1,126 ng/ml). When SK treatment is applied (group 2), FPA decreases to 52 ng/ml. Later treatment with heparin (group-3, 82; group-4, 44 and group-5, 81ng/ml) does not neutralize thrcmbinic activity. Patients treated only with heparin (group 6) show an FPAvalue of 19 ng/ml, which is lower than in the other groups. All of this indicates that thrombin is activated after fibrinolytic treatment. FDP values show asignificant increase in the six groups (1, 53; 2, 430; 3, 128; 4, 270; 5, 139 and 6, 141 ug/ml), which indicates that during treatment with heparin the fibrinolytic activity persists. he formation of highly cross-linked fibrin is altered in groups 1,2,3 and 4,as a consequence of circulating FDP effect and fibrincgeno- lysis.The permeability of the fibrin clotdecreases in groups 1 (0.42), 2 (1.3), 4 (1.1) and 5(0.5 ml/s/ng) and increases in group 2 (23.2 ml/s/nig) with respect to the normal plasma value (3.2 ml/s/nrg). The decrease in permeability must be related to the existence of hypercoagulability resistant to heparinization. FPA values, tine Fgl/Fgll ratio, andfibrin permeability can be used to evaluate the degree of thrcmbin activity during thrombolytic treatmentinAMI.

Estudo de fraturas nos taludes de corte, em rocha vulcânica, ao longo da BR 158, Santa Maria, RS

1999 ◽  
Vol 21 (21) ◽  
pp. 97
Author(s):  
Andrea V. Nummer ◽  
Luis Eduardo S. Robaina ◽  
Marcos Geovane Berger
Keyword(s):  
Conditioning Factors ◽  
Weathering Processes ◽  
Group 4 ◽  
Group 6 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Road Data ◽  
Santa Maria ◽  
Group 1

Weathering processes and jointing degree are the conditioning factors for rock falI.The fractured volcanic lithologies from Santa Maria, RS, Brazil, were studied along the BR 158 road. Data was gathered through the Scanline method from BRADY & BROWN (1985) and analyzed by vector statistics.Six main jointing groups were defined, associated to rock cooling and shrinking. Main attitudes are: Group 1: 348;83; Group 2: 174;82; Group 3: 85;76; Group 4: 265;75; Group 5: 300;42 and Group 6: 121 ;53.

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