scholarly journals Multifrecuency bioimpedance phase angle as a tool to predict maturation failure of native fistulae for hemodialysis

2021 ◽  
Vol 5 (2) ◽  
pp. 061-066
Author(s):  
Daza Lopez José Lucas ◽  
Galindo John F ◽  
Villaquiran Mónica R ◽  
Valenzuela Emilio D ◽  
Cardenas Andres ◽  
...  
Keyword(s):  
At Risk ◽  
Arteriovenous Fistula ◽  
Phase Angle ◽  
Vascular Access ◽  
Roc Curve ◽  
Statistical Significance ◽  
Bioelectrical Impedance ◽  
Hydration Status ◽  
P Value ◽  
Patients At Risk

Background and objectives: An arteriovenous fistula is considered to be an ideal vascular access for patients receiving hemodialysis, its main limitation is its high failure rate to achieve maturation and long-term functionality loss. Multiple strategies have attempted to identify patients at risk. Bioelectrical impedance has shown to be a valuable resource in the determination of the hydration status, and the measurement of the phase angle through this method has demonstrated to be a good indicator of the nutritional state and its related as a general marker of survival. The objective of this study is to analyze the role of plasma albumin and phase angle measured through bioelectrical impedance as tools useful for predicting failure of arteriovenous fistulas. Materials and methods: prospective observational study, including 104 patients with chronic kidney disease receiving hemodialysis who underwent a native arteriovenous fistula during a period of 24 months. Analyzing its clinical characteristics, laboratory and phase angle through electrical bioimpedance, both univariate and multivariate analysis was performed both with logistic regression, furthermore calculation of coordinates and ROC curve to establish a better cut-off point. Results: of the variables that were analyzed only the phase angle measurement showed statistical significance OR 2.61 (1.6 – 4.4) p - value 0.001 for predicting arteriovenous fistula failure. In female patients with a phase angle value of 3.25 had a 90% sensibility and 53% specificity for male patients a value of 3.58 showed a sensibility of 84% and a specificity of 52% with ROC curve of 0.78. Conclusion: phase angle through bioimpedance is a useful parameter, helpful in predicting failure of native arteriovenous fistula, it is also an important tool for identifying patients at risk, in early stages prior to the construction of a vascular access.

scholarly journals Multifrequency Bioimpedance Phase Angle as a Tool to Predict Maturation Failure of Native Fistulae for Hemodialysis

2021 ◽  
Vol 7 (3) ◽  
Author(s):  
Daza JL ◽  
Galindo JF ◽  
Villaquiran MR ◽  
Valenzuela ED ◽  
Cardenas A ◽  
...  
Keyword(s):  
Phase Angle ◽  
Bioelectrical Impedance ◽  
Hydration Status ◽  
Arteriovenous Fistulas ◽  
Multiple Strategies ◽  
Multifrequency Bioimpedance ◽  
Patients At Risk

Background and objectives: An arteriovenous fistula is considered to be an ideal vascular access for patients receiving hemodialysis, its main limitation is its high failure rate to achieve maturation and long-term functionality loss. Multiple strategies have attempted to identify patients at risk. Bioelectrical impedance has shown to be a valuable resource in the determination of the hydration status, and the measurement of the phase angle through this method has demonstrated to be a good indicator of the nutritional state and it’s related as a general marker of survival. The objective of this study is to analyze the role of plasma albumin and phase angle measured through bioelectrical impedance as tools useful for predicting failure of arteriovenous fistulas.

P2881Eligibility for a subcutaneous defibrillator based on standard 12-lead electrocardiogram

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
R Sakhi ◽  
D A M J Theuns ◽  
D Cosgun ◽  
M Michels ◽  
A F L Schinkel ◽  
...  
Keyword(s):  
At Risk ◽  
Validation Cohort ◽  
High Specificity ◽  
Implantable Defibrillator ◽  
P Value ◽  
Derivation Cohort ◽  
T Wave ◽  
Wave Inversion ◽  
Passing Rate ◽  
Patients At Risk

Abstract Background Currently, the eligibility for a subcutaneous implantable defibrillator (S-ICD) system relies on a pre-implant vector screening based on the automated screening tool (AST). Objective To determine 12-lead ECG characteristics associated with eligibility for an S-ICD in a heterogeneous population at risk for sudden cardiac death (SCD). The goal is to determine patient eligibility for S-ICD using the standard 12-lead ECG, thereby avoiding additional AST screening. Methods We prospectively evaluated the eligibility for an S-ICD in 254 consecutive patients at risk for SCD. We identified 12-lead ECG parameters which were independently associated with AST passing (≥1 vector) using multivariable logistical regression analysis in our derivation cohort. The final model was tested in a separate validation cohort. Results The overall passing rate was 92% in our derivation cohort. Independent 12-lead ECG characteristics associated with AST passing were QRS≤130 ms, absence of QRS/T discordance in lead II and R/T-ratio ≥3.5 in lead II (Table). Eighty-three of 254 patients (33%) fulfilled these three criteria and had a passing rate of 100%. Of the validation cohort, 37 of 60 patients (62%) fulfilled all three criteria and also had a passing rate of 100%. The interobserver agreement for applying the ECG model was 90% (Cohen's Kappa=0.80). Table 1 Variables Univariable Multivariable OR (95% CI) P-value OR (95% CI) P-value QRS ≤130 ms 9.65 (3.66–25.43) <0.01 8.09 (2.88–22.77) <0.01 QTc ≤450 ms 3.33 (1.18–9.54) 0.02 Absence of T-wave inversion in lead I 2.74 (1.03–7.25) 0.04 Absence of T-wave inversion in lead II 3.65 (1.29–10.33) 0.02 Absence of QRS/T-wave discordance in lead II 5.05 (1.98–12.92) <0.01 4.19 (1.49–11.74) <0.01 Absence of QRS/T-wave discordance in lead aVF 3.95 (1.53–10.19) <0.01 R/T-ratio ≥3.5 in lead II 3.58 (1.27–10.01) 0.02 4.21 (1.27–13.95) 0.02 R/T-ratio ≥3.5 in lead aVF 3.16 (1.18–8.42) 0.02 OR = odds ratio; CI = confidence interval. Figure 1 Conclusion Using the standard 12-lead ECG, we developed a simple screening model with a high specificity for S-ICD eligibility. Our results suggest that patients who fulfill the three ECG criteria do not need additional AST-screening. Therefore, we developed a simple flowchart to determine eligibility for an S-ICD that can be easily implemented in daily clinical practice (Figure).

Identification of Carotid Artery Calcifications on Digital Panoramic Radiograph in a Group of South Indian population: A Retrospective Study

2020 ◽  
Author(s):  
Vikas Reddy
Keyword(s):  
At Risk ◽  
Carotid Artery ◽  
Health Care Providers ◽  
Panoramic Radiography ◽  
Screening Method ◽  
P Value ◽  
South Indian Population ◽  
Care Providers ◽  
Dental Practitioners ◽  
Patients At Risk

Background: Stroke had been the leading cause of death in industrialized countries, following cardiovascular disease and cancer. Aim and Objective: The present study aims to evaluate the fact that dental practitioners as health care providers ought to play their part in the early detection of patients at risk of having a cerebrovascular stroke. Materials and Methods: Initial study design consisted of 1000 panoramic radiographs (PRs), which were taken for patients visiting the department of Oral Medicine and Radiology. Two examiners reviewed all the radiographs. Sixty-one patients were found to have suspected carotid artery calcifications. Out of them, only 43 patients were subjected to Doppler ultrasound for confirmation of the carotid artery calcifications (CAC's). Results: Out of the 61 patients suspected of having carotid calcifications, 30 were male (49.2%) and 31 were female (50.8%) P value=0.844.Patients with age group between 51-61 had higher incidence of calcifications on orthopanograph (OPG). Mean age of the patients with calcifications on OPG was 56.67±SD of 10.15(p =0.004). Of the final 43 subjects, only 11 patients were confirmed to have positive carotid calcifications in Doppler ultrasonography study. Out of 11 patients, only 9 patients had atherosclerotic plaques that were not hemodynamically important and 2 patients had less than 50% carotid artery stenosis. Based on the Kappa value of 0.397, the level of agreement would be moderate with p value <0.001. Conclusion: Our study suggests that panoramic radiography can be a significant measure for detecting stroke prone patient. The role of Dental practitioners can be extended further, and overcome certain obstacles before panoramic radiography can be implemented as a new screening method for patients at risk of having a stroke.

Phase angle as bioelectrical marker to identify elderly patients at risk of sarcopenia

2014 ◽  
Vol 58 ◽  
pp. 43-46 ◽  
Author(s):  
Claudia Basile ◽  
David Della-Morte ◽  
Francesco Cacciatore ◽  
Gaetano Gargiulo ◽  
Gianluigi Galizia ◽  
...  
Keyword(s):  
At Risk ◽  
Elderly Patients ◽  
Phase Angle ◽  
Patients At Risk

Latis™ Catheter: New Technology for Thrombectomy of Vascular access Grafts

2003 ◽  
Vol 4 (3) ◽  
pp. 118-122
Author(s):  
A.F. Schild ◽  
N.M. Baltodano ◽  
R. Elias ◽  
J. Livingstone ◽  
J. Raines
Keyword(s):  
Vascular Access ◽  
New Technology ◽  
Statistical Significance ◽  
Primary Patency ◽  
Rank Statistic ◽  
P Value ◽  
Vascular Access Surgery ◽  
Residual Thrombus ◽  
Number Of Passes ◽  
Access Surgery

Purpose The most common complication of vascular access surgery is thrombosis. This study compared the gold standard Fogarty Thrombectomy Catheter, to the new latis Catheter with an advanced monofilament matrix. Methods 30 patients with thrombosed access grafts were randomly assigned to undergo thrombectomy with the Fogarty or latis catheter. An angioscope measured remaining graft thrombi. Results Twenty-nine of 30 subjects were successfully thrombectomized. No statistical differences in age, gender, race, or extension graft requirements were found. Catheter use in the latis group was: 1 in 14 procedures, and 2 in 1 procedure; Fogarty group: 1 in 10 procedures, 2 in 3 procedures, and 3 in 2 procedures. The average number of catheter passes was: latis 3.06 (1–6 passes) and Fogarty 4.13 (1–9 passes). A trend in favor of the latis catheter was demonstrated; however, statistical significance was not reached (p = 0.067). The overall 6-month primary patency rates were latis (40%) and Fogarty (30%). The estimated patency at the 50th percentile for latis is 120 days and Fogarty 108 days. Statistical significance was not reached with a p-value of the Log-Rank statistic of 0.68 and a p-value of the Wilcoxon statistic of 0.78. Conclusions The latis and Fogarty catheters are very similar. However, the latis balloon is more rugged with fewer catheters used and reduced number of passes. A difference in primary patency could not be demonstrated. The angioscope identified significant residual thrombus despite no returning thrombus from the catheter. Consequently, our protocol is modified to include the angioscope.

scholarly journals PENGARUH EMOTIONAL FREEDOM TECHNIQUE (EFT) TERHADAP TINGKAT AGRESIFITAS PASIEN RESIKO PERILAKU KEKERASAN

2020 ◽  
Vol 6 (2) ◽  
pp. 9
Author(s):  
Rizki Muliani ◽  
Imam Abidin ◽  
Ridha Adawiyah
Keyword(s):  
At Risk ◽  
High Risk ◽  
Violent Behavior ◽  
Alternative Therapy ◽  
Sampling Technique ◽  
The Body ◽  
P Value ◽  
Patients At Risk ◽  
Risk Patients ◽  
Aggression Questionnaire

Mental disorders are abnormal conditions that are either physical or mental. Out of these neuropsychiatric conditions are recorded patients with different nursing issues, one of which is violent behavior. Aggression is a form of behavior that is intended to harm someone physically and mentally to violent behavior patients. Emotional Freedom Technique (EFT) is one of the therapies to address the problem of aggression in patients at risk for violent behavior, where EFT helps balance the energy in the body causing emotional disturbance. The purpose of this study was to find out the influence of EFT on the aggressiveness of patients' risk of violent behavior at West Java Provincial Hospital. The type of research used is pre-experiment with the design of One Group Pretest Posttest. The sample size was 19 with a purposive sampling technique. Data collection for aggression level using the Aggression Questionnaire, whereas for EFT implementation using EFT therapy implementation guide. EFT is performed for 5 days, 1 day for 7 minutes. Data were analyzed using the Paired T-test. The results showed that aggressiveness before EFT was nearly complete (89.5%) of high-risk patients with high levels of aggression, whereas aggressive levels after partial EFT (52.6%) of high-risk violence patients had high levels of aggression. The results showed p-value = 0.000 and it was concluded that there is an influence of the Emotional Freedom Technique on the level of aggression of patients at risk of violent behavior. Based on the results of this research it is recommended that the Emotional Freedom Technique (EFT) can be an alternative therapy in helping to deal with issues of aggression.

scholarly journals Body composition assessment among adults in Thika, Kiambu county, Kenya

2019 ◽  
Vol 7 (7) ◽  
pp. 2568
Author(s):  
Mututho L. N. ◽  
Kiboi W. K. ◽  
Waihenya R. N.
Keyword(s):  
Body Composition ◽  
Body Fat ◽  
Visceral Fat ◽  
Bioelectrical Impedance ◽  
The Body ◽  
Hydration Status ◽  
P Value ◽  
Fat Percentage ◽  
Body Composition Assessment ◽  
Cross Sectional

Background: Research has shown that body composition is directly related to health. Altered body composition, can greatly increase the risks of conditions such as cardiovascular disease and diabetes. Bioelectrical Impedance Analysis fosters early detection of an improper balance in the body composition, which allows for earlier intervention and prevention.Methods: This was a cross sectional analysis of body composition for adults who volunteered to be screened during a Nutrition week in Kiambu County, Kenya. A total of 301 adults were included in the assessment. Body Mass Index (BMI) and Body composition (body fat %, bone mass, muscle mass, visceral fat and water %) were measured using bioelectrical impedance analysis.Results: The age of the participants ranged from 18-99 years (mean 42.19±16.57 years). Most of the participants were males (53.5%). More than half (53.2%) of the participants had a poor BMI, 37.2% had high total body fat percentage, 12.6% had excess levels of visceral fat and 26.6% had poor water hydration status. Age (OR=0.095; p value <0.001; CI 0.033-0272) and visceral fat (r=0.74; p value <0.001) were significantly associated with the BMI. Females had a significantly higher BMI (P <0.001). Visceral fat was also positively correlated with age: r=0.74; P value <0.001.Conclusions: Sex, age and BMI were important determinants of body composition. Increased physical activity, appropriate dietary practices are crucial in maintaining a healthy BMI and body composition. For timely intervention regular nutrition screening should be promoted among different populations.

scholarly journals Bioelectrical impedance phase angle as a diagnostic indicator in thyroid cancer

2021 ◽  
Author(s):  
Zhenhong Du ◽  
Zhanwen Xiao ◽  
Jingqiang Zhu
Keyword(s):  
Thyroid Cancer ◽  
Phase Angle ◽  
Statistical Significance ◽  
Bioelectrical Impedance ◽  
Characteristic Parameter ◽  
Predictive Values ◽  
Tissue Properties ◽  
Phase Angle Difference ◽  
Significant Difference ◽  
Diagnostic Indicator

Abstract Background: Bioelectrical impedance spectroscopy (BIS) is a non-invasive and easy-to-use technique to distinguish tissue properties. Phase angle, determined by BIS, detects changes in tissue electrical properties. We aimed to study the feasibility and validity of phase angle in diagnosis of thyroid cancer for the first time. Methods: 226 invitro thyroid specimens in 210 patients from Department of Thyroid in West China Hospital of Sichuan University from March to November 2013 were collected. According to the location from thyroid cancer, thyroid specimens were divided into four groups: A, B, C and D. All of the groups were analyzed with phase angles respectively. The results were compared with final pathologic diagnosis. Results: Results showed that the phase angle is the characteristic parameter. The rank-sum test showed, the significant difference between the four groups and between two groups (P<0.05), with statistical significance. Our study showed 86% sensitivity and 72% specificity of mean phase angle difference (MPAD). The corresponding positive and negative predictive values were 78% and 82%, overall accuracy was 80%, the area under the ROC curve is 0.838. Conclusions: The study demonstrated that phase angle can be used to diagnose thyroid cancer. With further research, the phase angle may be a potential diagnostic indicator for the thyroid cancer.

Identification of Carotid Artery Calcifications on Digital Panoramic Radiograph in a Group of South Indian population: A Retrospective Study

2020 ◽  
Author(s):  
Vikas Reddy Gandluru
Keyword(s):  
At Risk ◽  
Carotid Artery ◽  
Health Care Providers ◽  
Panoramic Radiography ◽  
Screening Method ◽  
P Value ◽  
South Indian Population ◽  
Care Providers ◽  
Dental Practitioners ◽  
Patients At Risk

Background: Stroke had been the leading cause of death in industrialized countries, following cardiovascular disease and cancer. Aim and Objective: The present study aims to evaluate the fact that dental practitioners as health care providers ought to play their part in the early detection of patients at risk of having a cerebrovascular stroke. Materials and Methods: Initial study design consisted of 1000 panoramic radiographs (PRs), which were taken for patients visiting the department of Oral Medicine and Radiology. Two examiners reviewed all the radiographs. Sixty-one patients were found to have suspected carotid artery calcifications. Out of them, only 43 patients were subjected to Doppler ultrasound for confirmation of the carotid artery calcifications (CAC's). Results: Out of the 61 patients suspected of having carotid calcifications, 30 were male (49.2%) and 31 were female (50.8%) P value=0.844.Patients with age group between 51-61 had higher incidence of calcifications on orthopanograph (OPG). Mean age of the patients with calcifications on OPG was 56.67 ± SD of 10.15 (p=0.004). Of the final 43 subjects, only 11 patients were confirmed to have positive carotid calcifications in Doppler ultrasonography study. Out of 11 patients, only 9 patients had atherosclerotic plaques that were not hemodynamically important and 2 patients had less than 50% carotid artery stenosis. Based on the Kappa value of 0.397, the level of agreement would be moderate with p value <0.001. Conclusion: Our study suggests that panoramic radiography can be a significant measure for detecting stroke prone patient. The role of Dental practitioners can be extended further, and overcome certain obstacles before panoramic radiography can be implemented as a new screening method for patients at risk of having a stroke.

scholarly journals Association between interleukin-8 and severity of dengue shock syndrome in children

2016 ◽  
Vol 56 (2) ◽  
pp. 79 ◽  
Author(s):  
Suryadi N. N. Tatura ◽  
Dasril Daud ◽  
Irawan Yusuf ◽  
Sitti Wahyuni ◽  
Janno B. Bernadus
Keyword(s):  
Roc Curve ◽  
Predictive Value ◽  
Statistical Significance ◽  
Case Fatality ◽  
Dengue Shock Syndrome ◽  
Hemorrhagic Fever ◽  
Interleukin 8 ◽  
Clinical Deterioration ◽  
P Value ◽  
Major Health Problem

Background Dengue hemorrhagic fever (DHF) remains a major health problem in tropical countries. The case fatality rate (CFR) can be reduced from 45% to <1%, if dengue shock syndrome (DSS) is treated early and adequately. Early biomarkers for DSS outcomes in children are needed. Interleukin-8 (IL-8) might be one of the molecule, as it plays a role in the pathophysiology of DHF in children.Objective To assess IL-8 levels in pediatric DHF patients at various stages of illness severity and to determine the correlation between serum IL-8 concentration on admission and DSS outcomes in children.Methods A prospective cohort study was done in children with DSS who were admitted to the Pediatrics Department of Kandou Hospital, Manado. We measured subjects’ serum IL-8 levels at the time of DSS diagnosis and followed-up subjects until there was improvement or deterioration. An association between IL-8 and DSS outcome was analyzed using univariable logistic regression test. An ROC curve and Chi-square test were used to analyze the prognostic value of serum IL-8 levels. Statistical significance was considered to be a P value of <0.05 (power 80, β=0.20)..Results Fifty-eight children with DSS were included in this study. Twenty-seven subjects had clinical deterioration (to recurrent shock, prolonged shock or died). There was a significant association between elevated IL-8 levels and clinical deterioration in DSS (OR 116.7; 95%CI 18.0 to 756.0; P=0.0001). The ROC curve revealed an IL-8 cut-off level of 194.9 pg/mL, AUC 0.982, with sensitivity 89.3%, specificity 93.3%, positive predictive value (PPV) 92.6%, negative predictive value (NPV) 90.3%.Conclusion There is an association between elevated early serum IL-8 level and a DSS deterioration. Further prognostic studies are needed to confirm the predictive ability of serum IL-8 level on DSS deterioration in children.

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