Comparison of 24-Hour Electrocardiogram Parameters in Patients with Graves Disease Before and After Anti-Thyroid Therapy

Background: We aimed prospectively investigate the laboratory and electrocardiographic parameters (hearth rate, QRS, QT, QTc, Tpe, Tpe/QTc, arrhythmia prevalance) in patients with graves disease before and after antithyroid therapy. Methods: 71 patients (48 female, 23 male), age between 18-50 (mean±SD: 36.48±12.20 ) with GD were included into the study. Patients treated with antithyroid therapy (thionamids and/or surgical therapy) to maintain euthyroid status. Patients were examined in terms of electrocardiographic parameters before and after the treatment. Results: Mean TSH, free thyroxin (fT4) and tri-iodothyrionine (fT3) levels of all patients were 0.005±0.21, 3.27± 1.81, 11.42±7.44, respectively. While 9 patients (group 2) underwent surgical therapy, had suspicious of malignant nodule or large goiter and unresponsiveness to medical treatment; the other patients (n=62, group 1) were treated with medical therapy. Patients with surgical therapy had more increased serum fT4 (p=0.045), anti-thyroglobulin value (p=0.018) and more severe graves orbitopathy (n=0.051) before treatment when compared to medical therapy group. Baseline Tpe duration and baseline Tpe/QTc ratio and frequency of supraventricular ectopic beats were found to be significantly higher in group 2 when compared to group 1 (p=0.00, p=0.005). Otherwise baseline mean heart rate, QRS duration, QTc values of both groups were similar. Although the patients became their euthyroid status, group 2 patients had still suffered from more sustained supraventricular ectopics beats than group 1. Conclusion: Distinct from medical treatment group, surgical treatment group with euthyroidism at least 3 months had still suffered from an arrhythmia (Tpe, Tpe/QTc, supraventricular and ventricular ectopic beats).

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Sperm phenotypes in varicocele

Andrology and Genital Surgery ◽

10.17650/2070-9781-2019-20-4-24-33 ◽

2019 ◽

Vol 20 (4) ◽

pp. 24-33

Author(s):

O. B. Zhukov ◽

E. E. Bragina ◽

A. V. Levin

Keyword(s):

Surgical Treatment ◽

Treatment Group ◽

Conservative Treatment ◽

Control Group ◽

Sperm Ultrastructure ◽

Study Objective ◽

Sperm Analysis ◽

Before And After ◽

Group 2 ◽

Group 1

The study objective is to microscopically evaluate the morphology of sperm in patients with varicocele after surgical treatment and therapy with Prostatilen® AC.Materials and methods. The treatment group included 20 males between 26 and 45 years of age (mean age 31.6 ± 6.1 years) with various stages of varicocele and fertility problems; among them, 10 patients with subclinical stages of varicocele received conservative treatment with Prostatilen® AC (group 1) and were examined before and after the treatment; 10 males with infertility caused in part by varicocele of the spermatic cord veins were examined 6 months to 3 years after surgical treatment (group 2). Standard clinical and lab tests, sperm analysis, electron microscopy of the ejaculate were performed. The control group included 65 fertile males whose sperm samples were obtained from a bank of reproductive cells and tissues and used for comparison in microscopic examination.Results. In patients who received conservative treatment the number of sperm with immature chromatin decreased (p = 0.045) compared to the control group. This characteristic differed in patients after varicocelectomy and patients after conservative treatment (p = 0.037). Compared to control, the number of sperm with excess residual cytoplasm in the head and neck was higher in patients after varicocelectomy (p = 0.011). After conservative treatment, the number of sperm with excess residual cytoplasm was close to the control number and lower than in patients after varicocelectomy (р = 0.028).Conclusion. In patients with subclinical varicocele, conservative treatment with Prostatilen® AC leads to significant improvement in sperm ultrastructure compared to patients who underwent surgery to treat this pathology.

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PENGARUH PENAMBAHAN TRAKSI OSCILASI PADA TRANSCUTANEUS ELECTRICAL NERVE STIMULATION TERHADAP INTENSITAS NYERI PADA PENDERITA OSTEOARTHRITIS GENU

Jurnal Penelitian Keperawatan Medik ◽

10.36656/jpkm.v1i1.94 ◽

2018 ◽

Vol 1 (1) ◽

pp. 20-25

Author(s):

Isidorus Jehaman ◽

Redi Tantangan

Keyword(s):

Treatment Group ◽

Pain Intensity ◽

T Test ◽

Verbal Description ◽

P Value ◽

Degenerative Diseases ◽

Before And After ◽

Quasi Experimental ◽

Group 2 ◽

Group 1

Degenerative diseases are chronic chronic diseases that affect a person's quality of life and productivity. One of the most common degenerative diseases and which has a high mortality rate is osteoarthritis in the knee. The purpose of this study was to determine the differences in the administration of TENS with Oscillation Traction on pain intensity in patients with genital osteoarthritis in Grandmed Lubuk Pakam Hospital. Research Method: this is research is quasi-experimental while the research design uses pre-test and post-test. The sample of this study used 2 treatment groups, namely treatment group 1 using TENS and treatment group 2 using oscillation traction. Both sample groups measured pain scales using the verbal description scale. The results of the analysis of the influence test with Independent t-test in treatment group 1 and treatment group 2. Test paired sample t-test obtained p value = 0.001 (p 5 0.05), which means that there is a difference in pain intensity before and after being given TENS. Whereas in the treatment group 2 oscillation traction obtained results of p = 0.001 (.050.05) which means that there is a difference in pain intensity before and after being given oxyylation traction. From the results of the independent t-test in getting results with p = 0.000 (α<0.05) it can be concluded that there is a difference in the administration of TENS with oscillation traction against pain intensity in Genu Osteoarthtritis sufferers. Conclusion There is a Difference in Giving TENS with Oscillation Traction Against Pain Intensity in Genu Osteoarthtritis Patients. Suggestion: minimize activity overload the knee joint, squat up and down stairs or lift excessive weight.

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Surgically treated acromegaly patients have a similar quality of life whether controlled by surgery or requiring additional medical therapy (QuaLAT Study)

Pituitary ◽

10.1007/s11102-021-01153-4 ◽

2021 ◽

Author(s):

Muhammad Fahad Arshad ◽

Oluwafunto Ogunleye ◽

Richard Ross ◽

Miguel Debono

Keyword(s):

Quality Of Life ◽

Medical Treatment ◽

Physical Component Score ◽

Healthy Controls ◽

Component Score ◽

Post Surgery ◽

Group 3 ◽

Group 2 ◽

Group 1

Abstract Purpose There is no consensus on quality of life (QOL) in patients with acromegaly requiring medical treatment after surgery compared with those achieving remission by surgery alone. Methods QuaLAT is a cross-sectional study comparing QOL in surgery-only treated acromegaly patients versus those requiring medical treatment post-surgery. Patients attending clinics were identified and divided into—Group 1: patients who had surgery only and were in biochemical remission, Group 2: all patients on medical treatment post-surgery, Group 3: patients from Group 2 with biochemical control. Participants were asked to fill three questionnaires; Acromegaly Quality of Life Questionnaire (ACROQOL), 36-Item Short Form Survey (SF36), and Fatigue Severity Scale (FSS). Results There were 32 patients in Group 1 and 25 in Group 2. There was no difference in QOL scores between groups 1 and 2, as measured by ACROQOL (mean difference [MD] = − 2.5, 95% CI − 16.6 to 11.6; p = 0.72), SF36v2 [Physical component score (PCS) MD = − 4.9, 95% CI − 10.9 to 1.2; p = 0.12; mental component score MD = − 3.0, 95% CI − 10.5 to 4.4; p = 0.44], or FSS (MD = − 0.004, 95% CI − 1.14 to 1.33; p = 0.1). Comparison between groups 1 and 3 however showed that PCS (and 3 subdomains) was significantly better in group 3 (MD = − 8.3, 95% CI − 14.8 to -1.8; p = 0.01). All three QOL scores were lower when compared with healthy controls. Conclusions Medical treatment not only achieves a QOL comparable to surgery, it may also be associated with better QOL in physical subdomains. When compared with healthy controls, QOL remains worse in treated acromegaly patients compared to controls.

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Adaptive functional change of the contralateral kidney after partial nephrectomy

AJP Renal Physiology ◽

10.1152/ajprenal.00058.2017 ◽

2017 ◽

Vol 313 (2) ◽

pp. F192-F198 ◽

Cited By ~ 2

Author(s):

Se Young Choi ◽

Sangjun Yoo ◽

Dalsan You ◽

In Gab Jeong ◽

Cheryn Song ◽

...

Keyword(s):

Renal Function ◽

Partial Nephrectomy ◽

Functional Change ◽

Functional Changes ◽

Contralateral Kidney ◽

Before And After ◽

Group 2 ◽

American Society ◽

American Society Of Anesthesiologists ◽

Group 1

Partial nephrectomy aims to maintain renal function by nephron sparing; however, functional changes in the contralateral kidney remain unknown. We evaluate the functional change in the contralateral kidney using a diethylene triamine penta-acetic acid (DTPA) renal scan and determine factors predicting contralateral kidney function after partial nephrectomy. A total of 699 patients underwent partial nephrectomy, with a DTPA scan before and after surgery to assess the separate function of each kidney. Patients were divided into three groups according to initial contralateral glomerular filtration rate (GFR; group 1: <30 ml·min−1·1.73 m−2, group 2: 30–45 ml·min−1·1.73 m−2, and group 3: ≥45 ml·min−1·1.73 m−2). Multiple-regression analysis was used to identify the factors associated with increased GFR of the contralateral kidney over a 4-yr postoperative period. Patients in group 1 had a higher mean age and hypertension history, worse American Society of Anesthesiologists score, and larger tumor size than in the other two groups. The ipsilateral GFR changes at 4 yr after partial nephrectomy were −18.9, −3.6, and 3.9% in groups 1, 2, and 3, respectively, whereas the contralateral GFR changes were 10.8, 25.7, and 38.8%. Age [β: −0.105, 95% confidence interval (CI): −0.213; −0.011, P < 0.05] and preoperative contralateral GFR (β: −0.256, 95% CI: −0.332; −0.050, P < 0.01) were significant predictive factors for increased GFR of the contralateral kidney after 4 yr. The contralateral kidney compensated for the functional loss of the ipsilateral kidney. The increase of GFR in contralateral kidney is more prominent in younger patients with decreased contralateral renal function.

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A cross-sectional research conducted in Malatya province, Turkey: Knowledge levels and awareness about rational antibiotic use and antimicrobial resistance before and after graduation

10.21203/rs.2.19144/v1 ◽

2019 ◽

Author(s):

ADEM KOSE

Keyword(s):

Antimicrobial Resistance ◽

Family Physicians ◽

Antibiotic Use ◽

Theoretical Knowledge ◽

Cross Sectional ◽

Before And After ◽

Group 2 ◽

Senior Students ◽

Rational Antibiotic Use ◽

Group 1

Abstract Background Irrational antibiotic use can adversely affect treatment outcomes or even lead to increased antimicrobial resistance. We aimed to determine antimicrobial prescribing habits and to evaluate the level of theoretical knowledge of rational antibiotic use and awareness about antimicrobial resistance among the senior students of medical faculty and the family physicians in Malatya province in Turkey. Methods This study was cross-sectional research and was carried out between dates of 01 February-30 April 2019, in Malatya province. Power analysis was calculated as minimum 240 participants when considering a proportion difference of 0.18 between the groups, a type I error of 0.05 and a type II error of 0.20. A total 225 senior students in Inonu University Medical Faculty (Group 1) and 230 actively-working family physicians in Malatya primary healthcare services who were found eligible (Group 2) were included in to this study. A questionnaire form was prepared including seven sections and thirty questions. All of the participants were interviewed face to face. Before the questions, the purpose of the study and the contents of the questions were explained to participants. Qualitative data were analyzed by Pearson chi-square test. A p<0.05 value was considered to be statistically significant. Results The group 1 had a tendency to apply to specialist physician when starting to themselves antibiotic treatment, they were more cautious when making antibiotic decision, and their theoretical knowledge level was better. They argued that penal sanctions could be more effective by developing strict use policies to raise awareness of resistance to antibiotics. The group 2 had higher self-confidence and it was also concluded that forgot their theoretical antibiotic knowledge over time and could not follow the novel information because of the intensity of working life. Both groups stated that post-graduation trainings could be used effectively for reducing the antibiotic resistance. Conclusion This study highlighted the need for immediate action of training and corrective actions and might create awareness to determine the difference in theoretical knowledge levels and behavior models of physicians before and after graduation and to reduce higher use rates to lower levels. Key words: Antimicrobial resistance, antibiotic, awareness, rational use

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Abstract 14551: Biomarkers Predicting the Treatment-Resistant Kawasaki Disease

Circulation ◽

10.1161/circ.142.suppl_3.14551 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Yukako Yoshikane ◽

Ryuji Fukazawa ◽

Kyoko Imanaka-yoshida ◽

Naho Kobayashi ◽

Yasuhiro Katsube

Keyword(s):

Treatment Group ◽

Kawasaki Disease ◽

Predictive Value ◽

Scoring Systems ◽

Line Treatment ◽

Treatment Resistant ◽

Cutoff Value ◽

Group 3 ◽

Group 2 ◽

Group 1

Introduction: Kawasaki disease (KD), which is the most common multisystem vasculitis with unknown causes in childhood, causes coronary artery lesions (CALs). Treatment with a high dose of intravenous immunoglobulin (IVIG), plus steroids if needed, is the most effective therapy for the acute phase of KD. However, there are some very severe cases who need several times additional treatments and are at risk for CALs. In Japan, there are some scoring systems that initially predict IVIG-resistant patients. However, the problem is that these scoring systems fail in multiethnic populations. The aim of this study is to find universal biomarkers that predict treatment-resistant cases of KD. Methods: The subject was 276 KD patients, including Group 1 (n=214) who needed only 1 st line treatment, Group 2 (n=48) who needed 2 nd line treatment, Group 3 (n=14) who needed 3 rd line treatment or more. Tenascin C (TN-C), Pentraxin 3 (PTX3) and Procalcitonin (PCT) values, which were selected by systematic review, were measured before initial treatment in each group. Results: TN-C; 99.8±41.05 ng/ml in Group 1, 118.0±71.4 ng/ml in Group 2 and 183.0±25.0 ng/ml in Group 3. The TN-C level of Group 3 was significantly higher than that of all the others (p<0.01). The cutoff value for distinguishing Group 3 was 142.0 ng/ml (Area under the Curve (AUC)=0.81). PTX3; 16.2±9.0 ng/ml in Group 1, 31.4±19.7 ng/ml in Group 2 and 58.0±33.0 ng/ml in Group 3. The PTX3 level of Group 3 was significantly higher than that of all the others (p<0.01). The cutoff value for distinguishing Group 3 was 35.1 ng/ml (AUC=0.86). PCT; 0.79±0.77 ng/ml in Group 1, 2.55±3.01 ng/ml in Group 2 and 4.15±4.49 ng/ml in Group 3. The PCT level of Group 3 was significantly higher than that of all the others (p<0.01). The cutoff value for distinguishing Group 3 was 2.55 ng/ml (AUC=0.88). When those three biomarkers combined, Group 3 can be predicted with the sensitivity 79%, the specificity 96%, the positive predictive value 50% and the negative predictive value 99%. Conclusions: It may be possible to predict treatment-resistant KD cases with high sensitivity and specificity by combining the measurement from the universal biomarkers, TN-C, PTX3 and PCT, before initial treatment.

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The effect of hGH on hypothalamic-pituitary-thyroid function in patients with pituitary dwarfism

Acta Endocrinologica ◽

10.1530/acta.0.0930013 ◽

1980 ◽

Vol 93 (1) ◽

pp. 13-19 ◽

Cited By ~ 14

Author(s):

Reiko Demura ◽

Hajime Yamaguchi ◽

Ichiji Wakabayashi ◽

Hiroshi Demura ◽

Kazuo Shizume

Keyword(s):

Treatment Group ◽

Thyroid Function ◽

Half Life ◽

Good Growth ◽

Normal Range ◽

Pituitary Dwarfism ◽

Group 3 ◽

Group 2 ◽

Symptoms And Signs ◽

Group 1

Abstract. The effect of growth hormone (hGH) on the hypothalamic-pituitary-thyroid function was studied in patients with pituitary dwarfism. Twenty-six patients were given KABI hGH, 0.5 U/kg/week, for a period of 4—18 months. Three groups of patients were identified according to their T4 levels before and during the treatment. Group 1: T4 levels were initially normal and stayed in the normal range throughout a course of treatment. Group 2: T4 levels were initially normal but dropped to the subnormal range after hGH. Group 3: T4 levels were initially subnormal and decreased further after hGH. Changes in T4 levels after hGH in groups 2 and 3 were accompanied by a decrease in plasma T3RSU without concomitant decrease in plasma T3. Clinically, most of them lacked symptoms and signs of hypothyroidism and exhibited a good growth response to hGH. Plasma TSH response to TRH in these patients revealed a sustained delayed pattern, which was suggestive of hypothalamic hypothyroidism. This pattern of TSH response to TRH became further exaggerated after hGH therapy. In contrast, TSH response to TRH among patients in group 1 was normal and was not influenced by hGH. Administration of 4.0 U of KABI hGH daily for 21 consecutive days to 3 patients resulted in a shortened half-life of T4 and inversely prolonged that of T3. These results suggest that various degrees of TRH deficiency exist among patients with idiopathic pituitary dwarfism. Therapy with hGH discloses a mild TRH deficiency by accelerating the half-life of T4. This also causes a further drop in the T4 levels in those with marked TRH deficiency. The development of clinical hypothyroidism is not so obvious in these patients because of inverse delay in half-life of T3 by hGH.

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Attitude of the Canine in Secondary Bone-Grafted and Nongrafted Patients with Cleft Lip and Palate

The Cleft Palate-Craniofacial Journal ◽

10.1597/04-016.1 ◽

2005 ◽

Vol 42 (6) ◽

pp. 679-686 ◽

Cited By ~ 15

Author(s):

Enkhtuvshin Gereltzul ◽

Yoshiyuki Baba ◽

Kimie Ohyama

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Panoramic Radiography ◽

Control Groups ◽

Significant Difference ◽

Before And After ◽

Group 2 ◽

Two Stages ◽

And Control ◽

Group 1

Objective To investigate the eruption pattern of the cleft-side canine regarding its pre-eruption position relative to the cleft in bone-grafted (BG) and nongrafted (NonBG) patients with cleft lip and palate. Methods Fifty-three patients with cleft lip and palate (21 BG, 32 NonBG) were examined by panoramic radiography and posteroanterior cephalography taken before and after canine eruption. Subjects were categorized into BG, NonBG, and control groups. Canines at the pre-eruption stage were categorized as close to (group 1) or distant from (group 2) the cleft area. The canine angle and its change between the two stages were evaluated. Results No significant differences were noted between the initial canine angle of the BG and NonBG groups. Although canines in the BG group erupted without a significant change in angle, the canine angle increased significantly (p < .0001) in the NonBG and control groups. In group 1, a greater change in canine angle was noted in the NonBG (p < .05) and control (p < .01) groups than in the BG group. In group 2, no significant difference was noted among the three groups. Conclusions In BG patients, a canine located near the cleft appears to erupt at the same angle as it had before grafting. However, in NonBG patients, it erupts more vertically, guided by cortical bone. For canines distant from the cleft area, there is no significant difference in the change in angulation between NonBG and BG patients.

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The effect of capped biparametric magnetic resonance imaging slots on weekly prostate cancer imaging workload

British Journal of Radiology ◽

10.1259/bjr.20190929 ◽

2020 ◽

Vol 93 (1108) ◽

pp. 20190929 ◽

Cited By ~ 3

Author(s):

Nikita Sushentsev ◽

Iztok Caglic ◽

Evis Sala ◽

Nadeem Shaida ◽

Rhys A Slough ◽

...

Keyword(s):

Prostate Cancer ◽

Mean Absolute Deviation ◽

Resonance Imaging ◽

Absolute Deviation ◽

Intergroup Comparison ◽

Before And After ◽

Group 2 ◽

Group 1

Objective: To introduce capped biparametric (bp) MRI slots for follow-up imaging of prostate cancer patients enrolled in active surveillance (AS) and evaluate the effect on weekly variation in the number of AS cases and total MRI workload. Methods: Three 20 min bpMRI AS slots on two separate days were introduced at Addenbrooke’s Hospital, Cambridge. The weekly numbers of total prostate MRIs and AS cases recorded 15 months before and after the change (Groups 1 and 2, respectively). An intergroup variation in the weekly scan numbers was assessed using the coefficient of variance (CV) and mean absolute deviation; the Mann–Whitney U test was used for an intergroup comparison of the latter. Results: In AS patients, a shift from considerable to moderate variation in weekly scan numbers was observed between the two groups (CV, 51.7 and 26.8%, respectively); mean absolute deviation of AS scans also demonstrated a significant decrease in Group 2 (1.28 vs 2.58 in Group 1; p < 0.001). No significant changes in the variation in total prostate MRIs were observed, despite a 10% increased workload in Group 2. Conclusion: A significant reduction in weekly variation of AS cases was demonstrated following the introduction of capped bpMRI slots, which can be used for more accurate long-term planning of MRI workload. Advances in knowledge: The paper illustrates the potential of introducing capped AS MRI slots using a bp protocol to reduce weekly variation in demand and allow for optimising workflow, which will be increasingly important as the demands on radiology departments increase worldwide.

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Endothelium-derived hyperpolarizing factor in preeclampsia: heterogeneous contribution, mechanisms, and morphological prerequisites

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.00458.2007 ◽

2008 ◽

Vol 294 (2) ◽

pp. R510-R519 ◽

Cited By ~ 35

Author(s):

Leanid Luksha ◽

Henry Nisell ◽

Natallia Luksha ◽

Marius Kublickas ◽

Kjell Hultenby ◽

...

Keyword(s):

Electron Microscopy ◽

Transmission Electron Microscopy ◽

Subcutaneous Fat ◽

Normal Pregnancy ◽

Transmission Electron ◽

Main Pathway ◽

Before And After ◽

Group 2 ◽

Cytochrome P 450 ◽

Group 1

We hypothesized that in preeclampsia (PE), contribution of endothelium-derived hyperpolarizing factor (EDHF) and the mechanism/s of its action differ from that in normal pregnancy (NP). We aimed to assess endothelial function and morphology in arteries from NP and PE with particular focus on EDHF. Arteries (≈200 μm) were dissected from subcutaneous fat biopsies obtained from women undergoing cesarean section. With the use of wire myography, responses to the endothelium-dependent agonist bradykinin (BK) were determined before and after inhibition of pathways relevant to EDHF activity. The overall responses to BK in arteries from PE ( n = 13) and NP ( n = 17) were similar. However, in PE, EDHF-mediated relaxation was reduced ( P < 0.05). All women within the PE group were divided into two subgroups: with more ( group 1) or less ( group 2) than 50% reduction of EDHF-typed responses after 18-α-glycyrrhetinic acid (an inhibitor of myoendothelial gap junctions, MEGJs). The division showed that 1) MEGJs are principally involved when the EDHF contribution is reduced; and 2) when the EDHF contribution is similar to that in NP, the H2O2 and/or cytochrome P-450 epoxygenase products of arachidonic acid (AA), along with MEGJs, confer EDHF-mediated relaxation. In contrast, MEGJs were the main pathway for EDHF in NP. The abundant presence of MEGJs in arteries from NP but deficiency of them in PE was observed using transmission electron microscopy. We conclude that PE is associated with heterogeneous contribution of EDHF, and the mechanism behind EDHF-typed responses is mediated either by MEGJs alone or in combination with H2O2 or cytochrome P-450 epoxygenase metabolites of AA.

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