scholarly journals Association Between Apelin and Atrial Fibrillation in Patients With High Risk of Ischemic Stroke

2021 ◽  
Vol 8 ◽  
Author(s):  
Allan Bohm ◽  
Peter Snopek ◽  
Lubomira Tothova ◽  
Branislav Bezak ◽  
Nikola Jajcay ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Logistic Regression ◽  
High Risk ◽  
Area Under The Curve ◽  
Study Groups ◽  
Diagnostic Value ◽  
Screening Tools ◽  
Bivariate Analysis ◽  
Control Group ◽  
Timely Initiation

Background: Atrial fibrillation (AF) is associated with high risk of stroke preventable by timely initiation of anticoagulation. Currently available screening tools based on ECG are not optimal due to inconvenience and high costs. Aim of this study was to study the diagnostic value of apelin for AF in patients with high risk of stroke.Methods: We designed a multicenter, matched-cohort study. The population consisted of three study groups: a healthy control group (34 patients) and two matched groups of 60 patients with high risk of stroke (AF and non-AF group). Apelin levels were examined from peripheral blood.Results: Apelin was significantly lower in AF group compared to non-AF group (0.694 ± 0.148 vs. 0.975 ± 0.458 ng/ml, p = 0.001) and control group (0.982 ± 0.060 ng/ml, p < 0.001), respectively. Receiver operating characteristic (ROC) analysis of apelin as a predictor of AF scored area under the curve (AUC) of 0.658. Apelin's concentration of 0.969 [ng/ml] had sensitivity = 0.966 and specificity = 0.467. Logistic regression based on manual feature selection showed that only apelin and NT-proBNP were independent predictors of AF. Logistic regression based on selection from bivariate analysis showed that only apelin was an independent predictor of AF. A logistic regression model using repeated stratified K-Fold cross-validation strategy scored an AUC of 0.725 ± 0.131.Conclusions: Our results suggest that apelin might be used to rule out AF in patients with high risk of stroke.

scholarly journals Sphingolipid Analysis Indicate Lactosylceramide as a Potential Biomarker of Inflammatory Bowel Disease in Children

Biomolecules ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. 1083
Author(s):  
Aleksandra Filimoniuk ◽  
Agnieszka Blachnio-Zabielska ◽  
Monika Imierska ◽  
Dariusz Marek Lebensztejn ◽  
Urszula Daniluk
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
High Performance ◽  
Area Under The Curve ◽  
Study Groups ◽  
Diagnostic Value ◽  
Serum Samples ◽  
Specificity And Sensitivity ◽  
Potential Biomarker ◽  
Inflammatory Bowel

An altered ceramide composition in patients with inflammatory bowel disease (IBD) has been reported recently. The aim of this study was to evaluate the concentrations of sphingolipids in the serum of treatment-naive children with newly diagnosed IBD and to determine the diagnostic value of the tested lipids in pediatric IBD. The concentrations of sphingolipids in serum samples were evaluated using a quantitative method, an ultra-high-performance liquid chromatography-tandem mass spectrometry in children with Crohn’s disease (CD) (n=34), ulcerative colitis (UC) (n = 39), and controls (Ctr) (n = 24). Among the study groups, the most significant differences in concentrations were noted for C16:0-LacCer, especially in children with CD compared to Ctr or even to UC. Additionally, the relevant increase in C20:0-Cer and C18:1-Cer concentrations were detected in both IBD groups compared to Ctr. The enhanced C24:0-Cer level was observed only in UC, while C18:0-Cer only in the CD group. The highest area under the curve (AUC), specificity, and sensitivity were determined for C16:0-LacCer in CD diagnosis. Our results suggest that the serum LacC16-Cer may be a potential biomarker that distinguishes children with IBD from healthy controls and differentiates IBD subtypes. In addition, C20:0-Cer and C18:0-Cer levels also seem to be closely connected with IBD.

scholarly journals Diagnostic Value of Vaginal Microecology, Serum miR-18a, and PD-L1 for Identifying HPV-Positive Cervical Cancer

2021 ◽  
Vol 20 ◽  
pp. 153303382199528
Author(s):  
Yumei Zhang ◽  
Sujuan Qiu ◽  
Yueli Guo ◽  
Jiaqin Zhang ◽  
Xiaoqing Wu ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Area Under The Curve ◽  
Serum Levels ◽  
Diagnostic Value ◽  
High Serum ◽  
Control Group ◽  
Observation Group ◽  
Positive Group ◽  
Microbial Dysbiosis ◽  
Programmed Death

Objective: We aimed to investigate the diagnostic value of the vaginal microecology, serum miR-18a, and programmed death ligand-1 (PD-L1) for human papillomavirus (HPV)-positive cervical cancer. Methods: Eighty-four patients with HPV-positive cervical cancer were assigned to the observation group, 107 HPV-positive patients without cervical cancer were assigned to the positive group, and 191 healthy women were assigned to the control group. Vaginal microecology and serum levels of miR-18a and PD-L1 on the surface of CD4+ and CD8+ T cells were compared among the 3 groups. The observation group was further divided into subgroups according to patients’ characteristics for comparison. The diagnostic value of miR-18a and PD-L1 for HPV-positive cervical cancer was investigated. Results: Women in the control group had better vaginal microecology and lower levels of miR-18a and PD-L1 than those in the observation and the positive groups (all P < 0.05). Compared with the positive group, the observation group had similar vaginal microecology (all P > 0.05) but higher levels of miR-18a and PD-L1 (all P < 0.05). Moreover, the patients at stage III had higher levels of miR-18a and PD-L1 than those at stage I and II (all P < 0.05). The values of area under the curve for miR-18a and PD-L1 in the diagnosis of HPV-positive cervical cancer were over 0.8 (all P < 0.001). Conclusion: Patients with HPV-positive cervical cancer have vaginal microbial dysbiosis and high serum levels of miR-18a and PD-L1. miR-18a and PD-L1 have diagnostic value for identifying HPV-positive cervical cancer.

scholarly journals Cardiorespiratory Polygraphy for Detection of Obstructive Sleep Apnea in Patients With Atrial Fibrillation

2021 ◽  
Vol 8 ◽  
Author(s):  
Michiel Delesie ◽  
Lieselotte Knaepen ◽  
Johan Verbraecken ◽  
Karolien Weytjens ◽  
Paul Dendale ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Screening Tool ◽  
Area Under The Curve ◽  
Screening Tools ◽  
Apnea Hypopnea Index ◽  
Automated Algorithm ◽  
Obstructive Sleep ◽  
At Home

Background: Obstructive sleep apnea (OSA) is a modifiable risk factor of atrial fibrillation (AF) but is underdiagnosed in these patients due to absence of good OSA screening pathways. Polysomnography (PSG) is the gold standard for diagnosing OSA but too resource-intensive as a screening tool. We explored whether cardiorespiratory polygraphy (PG) devices using an automated algorithm for Apnea-Hypopnea Index (AHI) determination can meet the requirements of a good screening tool in AF patients.Methods: This prospective study validated the performance of three PGs [ApneaLink Air (ALA), SOMNOtouch RESP (STR) and SpiderSAS (SpS)] in consecutive AF patients who were referred for PSG evaluation. Patients wore one of the three PGs simultaneously with PSG, and a different PG during each of three consecutive nights at home. Severity of OSA was classified according to the AHI during PSG (&lt;5 = no OSA, 5–14 = mild, 15–30 = moderate, &gt;30 = severe).Results: Of the 100 included AF patients, PSG diagnosed at least moderate in 69% and severe OSA in 33%. Successful PG execution at home was obtained in 79.1, 80.2 and 86.8% of patients with the ALA, STR and SpS, respectively. For the detection of clinically relevant OSA (AHI ≥ 15), an area under the curve of 0.802, 0.772 and 0.803 was calculated for the ALA, STR and SpS, respectively.Conclusions: This study indicates that home-worn PGs with an automated AHI algorithm can be used as OSA screening tools in AF patients. Based on an appropriate AHI cut-off value for each PG, the device can guide referral for definite PSG diagnosis.

Diagnostic efficacy of serum and urinary netrin-1 in the early detection of diabetic nephropathy

2021 ◽  
pp. jim-2021-001785
Author(s):  
Rasha A Elkholy ◽  
Reham L Younis ◽  
Alzahraa A Allam ◽  
Rasha Youssef Hagag ◽  
Muhammad Tarek Abdel Ghafar
Keyword(s):  
Diabetic Nephropathy ◽  
Early Detection ◽  
Characteristic Curve ◽  
Fasting Blood Glucose ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Control Group ◽  
Diagnostic Efficacy ◽  
Significant Difference ◽  
Patients With Diabetes

This study aimed to assess the diagnostic value of serum and urinary netrin-1 in patients with type 2 diabetes mellitus (T2DM) at different stages of diabetic nephropathy (DN) and to compare its efficacy of estimation in serum with that in the urine. This study was carried out on 135 patients with T2DM and 45 healthy subjects. The patients with diabetes were divided according to urinary albumin creatinine ratio (UACR) into: T2DM with normoalbuminuria, incipient DN with microalbuminuria, and overt DN with macroalbuminuria groups. Serum and urinary levels of netrin-1 were measured by ELISA. The mean levels of serum and urinary netrin-1 were significantly higher in the microalbuminuric and macroalbuminuric patients with DN than those in the normoalbuminuric patients with T2DM, with the highest values detected in macroalbuminuric patients with DN. Urinary netrin-1 level was significantly higher in the normoalbuminuric T2DM group than control group, whereas no significant difference existed regarding serum netrin-1 level. In T2DM groups, the urinary and serum netrin-1 correlated with each other and were independently related to fasting blood glucose, UACR, and estimated glomerular filtration rate. Receiver operating characteristic curve analysis showed that the area under the curve of urinary netrin-1 was 0.916 which is significantly higher than that of serum netrin-1 (0.812) for the detection of incipient DN and reached 0.938 on coestimation of both urinary and serum netrin-1. In conclusion, netrin-1 is a potential diagnostic marker for early detection of DN with its estimation in urine has higher accuracy than that of serum.

scholarly journals Effects of eye cover among high risk neonates at night shift on their distress levels

2019 ◽  
Vol 9 (7) ◽  
pp. 9
Author(s):  
Eman Ali Moselhi Mater ◽  
Huda Shawky Mahamud ◽  
Mohamed Farouk Mohamed
Keyword(s):  
High Risk ◽  
Night Shift ◽  
Newborn Infants ◽  
Study Groups ◽  
University Hospital ◽  
Control Group ◽  
Stressful Environment ◽  
Distress Level ◽  
Significant Difference ◽  
The Mean

Background and aim: The Neonatal Intensive Care Unit (NICU) is a stressful environment for high risk neonates. Persistent bright light is one of the main environmental stressors that are distressed newborn infants in NICU. Cycled lighting may decrease distress level of newborn infants by enhancing calming status. This study aimed to investigate effects of eye cover among high risk neonates at night shift on their distress levels.Methods: Quasi experimental research design was carried out on a randomized sample of 60 newborn infants attending the NICU of El Manial University Hospital (Kasr Al Ainy), (30 control group and 30 study group). Neonatal assessment tool and COMFORTneoNRS scale were utilized for data collection.Results: There was a statistically significant difference between control and study groups regarding the distress levels (p < .00). The mean score of distress levels were 6.80 ± 1.80 and 0.80 ± 1.15 respectively and the mean score of comfort levels in the newborn infants in the control and study groups were 23.22 ± 5.50 and 6.60 ± 1.06 respectively. Eye coved enhanced quite sleep (66.7%), relaxed muscle (73.3%), decrease movement (66.7%) and no crying (85.7%).Conclusions: The use of eye cover among high risk neonates at night shift is effective to decrease their distress level and improve their comfort state in the morning shift by promoting quite sleep and relaxation. Recommendations: The educational program is needed to raise awareness among neonatal nurses about the effect of light reduction methods such as eye patches on the distress level and comfort state that enhances the growth and development of newborn infants.

scholarly journals Development and Validation of Two Self-Reported Tools for Insulin Resistance and Hypertension Risk Assessment in A European Cohort: The Feel4Diabetes-Study

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 960
Author(s):  
Spyridon Kanellakis ◽  
Christina Mavrogianni ◽  
Kalliopi Karatzi ◽  
Jaana Lindstrom ◽  
Greet Cardon ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Risk Assessment ◽  
High Risk ◽  
Sensitivity And Specificity ◽  
Low Cost ◽  
Area Under The Curve ◽  
Assessment Tools ◽  
Screening Tools ◽  
Model Assessment ◽  
Sugary Drinks

Early identification of type 2 diabetes mellitus (T2DM) and hypertension (HTN) risk may improve prevention and promote public health. Implementation of self-reported scores for risk assessment provides an alternative cost-effective tool. The study aimed to develop and validate two easy-to-apply screening tools identifying high-risk individuals for insulin resistance (IR) and HTN in a European cohort. Sociodemographic, lifestyle, anthropometric and clinical data obtained from 1581 and 1350 adults (baseline data from the Feel4Diabetes-study) were used for the European IR and the European HTN risk assessment index respectively. Body mass index, waist circumference, sex, age, breakfast consumption, alcohol, legumes and sugary drinks intake, physical activity and sedentary behavior were significantly correlated with Homeostatic Model Assessment of IR (HOMA-IR) and/or HTN and incorporated in the two models. For the IR index, the Area Under the Curve (AUC), sensitivity and specificity for identifying individuals above the 75th and 95th of HOMA-IR percentiles were 0.768 (95%CI: 0.721–0.815), 0.720 and 0.691 and 0.828 (95%CI: 0.766–0.890), 0.696 and 0.778 respectively. For the HTN index, the AUC, sensitivity and specificity were 0.778 (95%CI: 0.680–0.876), 0.667 and 0.797. The developed risk assessment tools are easy-to-apply, valid, and low-cost, identifying European adults at high risk for developing T2DM or having HTN.

scholarly journals Lipoprotein-Associated Phospholipase A2 Is a Risk Factor for Patients With Parkinson’s Disease

2021 ◽  
Vol 15 ◽  
Author(s):  
Zubo Wu ◽  
Suyuan Wu ◽  
Tao Liang ◽  
Lin Wang
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Logistic Regression ◽  
Risk Factor ◽  
Phospholipase A2 ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Multivariable Logistic Regression Analysis ◽  
Disease Course ◽  
Clinical Value

ObjectiveTo explore the association between lipoprotein-related phospholipase A2 (Lp-PLA2) and the risk of Parkinson’s disease (PD).MethodsA case-control study involving 58 hospitalized PD patients and 60 healthy controls was carried out. Serum Lp-PLA2 level was detected. According to the disease course and severity, PD patients were subdivided to analyze the clinical value of Lp-PLA2. Relationship between Lp-PLA2 and PD risk was analyzed by logistic regression. Diagnostic value of Lp-PLA2 in PD patients was investigated using receiver’s operator characteristic curves.ResultsLp-PLA2 level was significantly higher in the PD patients compared with the controls, and was significantly and positively correlated with the Hoehn-Yahr (H&amp;Y) stage. The serum Lp-PLA2 level and H&amp;Y stage of PD patients with a longer disease course were significantly higher than those with a shorter disease course. PD patients with milder conditions had significantly lower serum Lp-PLA2 levels than patients with severe conditions. Multivariable logistic regression analysis indicated higher Lp-PLA2 level was an independent risk factor of PD patients. Moreover, the area under the curve for Lp-PLA2 was 0.703, which was between those of homocysteine and serum amylase A.ConclusionTo our knowledge, this is the first study to show that increased level of Lp-PLA2 is associated with the risk of PD. Lp-PLA2 may be used for early detection of PD, and provides an effective intervention target for clinical treatment of PD.

scholarly journals SURGICAL TREATMENT OF ATRIAL FIBRILLATION IN ELDERLY PATIENTS UNDERGOING HIGH RISK CARDIAC SURGERY

2021 ◽  
Author(s):  
Mohsin Uzzaman ◽  
Imthiaz Manoly ◽  
Mohini Panikkar ◽  
Maciej Matuszewski ◽  
Nicolas Nikolaidis ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Surgical Treatment ◽  
High Risk ◽  
Elderly Patients ◽  
Control Group ◽  
Surgical Ablation ◽  
Af Ablation

BACKGROUND/AIM To evaluate outcomes of concurrent Cox-Maze procedures in elderly patients undergoing high-risk cardiac surgery. MEHODS We retrospectively identified patients aged over 70 years with Atrial Fibrillation (AF) from 2011 to 2017 who had two or more other cardiac procedures. They were subdivided into two groups: 1. Cox-Maze IV AF ablation 2. No-Surgical AF treatment. Patients requiring redo procedures or those who had isolated PVI or LAAO were excluded. Heart rhythm assessed from Holter reports or 12-lead ECG. Follow-up data collected through telephone consultations and medical records. RESULTS There were 239 patients. Median follow up was 61 months. 70 patients had Cox-Maze IV procedures (29.3%). Demographic, intra- and post-operative outcomes were similar between groups although duration of pre-operative AF was shorter in Cox-Maze group (p=0.001). One (1.4%) patient in Cox maze group with 30-day mortality compared to 14 (8.2%) the control group (p=0.05). Sinus rhythm at annual and latest follow-up was 84.9% and 80.0% respectively in Maze group - significantly better than No-Surgical AF treatment groups (P<0.001). 160 patients (66.9%) were alive at long-term follow-up with better survival curves in Cox Maze group compared to No-Surgical treatment group (p=0.02). There was significantly higher proportion of patients in NYHA 1 status in Cox-Maze group (p=0.009). No differences observed in freedom from stroke (p=0.80) or permanent pacemaker (p=0.33). CONCLUSIONS. Surgical ablation is beneficial in elderly patients undergoing high-risk surgery - promoting excellent long-term freedom from AF and symptomatic/prognostic benefits. Therefore, surgical risk need not be reason to deny benefits of concomitant AF-ablation.

scholarly journals A Novel Paradigm Based on ST2 and Its Contribution towards a Multimarker Approach in the Diagnosis and Prognosis of Heart Failure: A Prospective Study during the Pandemic Storm

Life ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1080
Author(s):  
Radu-Stefan Miftode ◽  
Daniela Constantinescu ◽  
Corina Maria Cianga ◽  
Antoniu Octavian Petris ◽  
Amalia-Stefana Timpau ◽  
...  
Keyword(s):  
Heart Failure ◽  
Area Under The Curve ◽  
Serum Levels ◽  
Diagnostic Value ◽  
Control Group ◽  
Diagnosis And Prognosis ◽  
Test Kit ◽  
Positive Correlations ◽  
Lactate Levels ◽  
A Prospective Study

Background: Acute heart failure (HF) represents an increasingly common and challenging presentation in the emergency room, also inducing a great socio-economic burden. Extensive research was conducted toward finding an ideal biomarker of acute HF, both in terms of sensitivity and specificity, but today practicians’ interest has shifted towards a more realistic multimarker approach. Natriuretic peptides (NPs) currently represent the gold standard for diagnosing HF in routine clinical practice, but novel molecules, such as sST2, emerge as potentially useful biomarkers, providing additional diagnostic and prognostic value. Methods: We conducted a prospective, single-center study that included 120 patients with acute HF and 53 controls with chronic HF. Of these, 13 patients (eight with acute HF, five from the control group) associated the coronavirus-19 disease (COVID-19). The diagnosis of HF was confirmed by a complete clinical, biological and echocardiographic approach. Results: The serum levels of all studied biomarkers (sST2, NT-proBNP, cardiac troponin) were significantly higher in the group with acute HF. By area under the curve (AUC) analysis, we noticed that NT-proBNP (AUC: 0.976) still had the best diagnostic performance, closely followed by sST2 (AUC: 0.889). However, sST2 was a significantly better predictor of fatal events, showing positive correlations for both in-hospital and at 1-month mortality rates. Moreover, sST2 was also associated with other markers of poor prognosis, such as the use of inotropes or high lactate levels, but not with left ventricle ejection fraction, age, body mass index or mean arterial pressure. sST2 levels were higher in patients with a positive history of COVID-19 as compared with non-COVID-19 patients, but the differences were statistically significant only within the control group. Bivariate regression showed a positive and linear relationship between NT-proBNP and sST2 (r(120) = 0.20, p < 0.002). Conclusions: we consider that sST2 has certain qualities worth integrating in a future multimarker test kit alongside traditional biomarkers, as it provides similar diagnostic value as NT-proBNP, but is emerging as a more valuable prognostic factor, with a better predictive value of fatal events in patients with acute HF.

scholarly journals Permanent Bilateral Carotid Filters for Stroke Prevention in Atrial Fibrillation

2020 ◽  
Vol 22 (11) ◽  
Author(s):  
Tom De Potter ◽  
Ofer Yodfat ◽  
Guy Shinar ◽  
Avraham Neta ◽  
Vivek Y. Reddy ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
High Risk ◽  
Stroke Prevention ◽  
Control Group ◽  
Future Directions ◽  
Mechanical Filter ◽  
Bilateral Carotid ◽  
The Common

Abstract Purpose of Review A novel permanent carotid filter device for percutaneous implantation was developed for the purpose of stroke prevention. In this review, we cover rationale, existing preclinical and clinical data, and potential future directions for research using such a device. Recent Findings The Vine™ filter was assessed for safety in sheep and in 2 observational human studies, the completed CAPTURE 1 (n = 25) and the ongoing CAPTURE 2 (planned n = 100). CAPTURE 1 has shown high procedural and long-term implant safety. A control group was not available for comparison. Summary A mechanical filter for permanent stroke prevention can be implanted bilaterally in the common carotid artery safely and efficiently. A randomized trial is planned for 2021 (n = 3500, INTERCEPT) to demonstrate superiority of a filter + anticoagulation strategy over anticoagulation alone in patients at high risk for ischemic stroke.

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