Reference diameter and characteristics of the distal radial artery based on ultrasonographic assessment

Background/Aims: While distal radial artery (DRA) access is increasingly being used for diagnostic coronary angiography, limited information is available regarding DRA size. We aimed to determine the DRA reference diameters of Korean patients and identify the predictors of DRA diameter < 2.3 mm.Methods: The outer bilateral DRA diameters were assessed using a linear ultrasound probe in 1,162 consecutive patients who underwent transthoracic echocardiography. The DRA diameter was measured by the perpendicular angle in the dorsum of the hand, and the average values were compared by sex. DRA diameter < 2.3 mm was defined as unsuitable for routine diagnostic coronary angiography using a 5 Fr introducer sheath.Results: The mean DRA diameters were 2.31 ± 0.43 mm (right) and 2.35 ± 0.45 mm (left). The DRA was smaller in women than men (right: 2.15 ± 0.38 mm vs. 2.43 ± 0.44 mm, p < 0.001; left: 2.18 ± 0.39 mm vs. 2.47 ± 0.45 mm, p < 0.001). The DRA diameter was approximately 20% smaller than the radial artery diameter. A total of 630 (54.2%) and 574 (49.4%) patients had DRA diameter < 2.3 mm in the right and left hands, respectively. Female sex, low body mass index (BMI), and low body surface area (BSA) were significant predictors of DRA diameter < 2.3 mm.Conclusions: We provided reference DRA diameters for Korean patients. Approximately 50% of the studied patients had DRA diameter < 2.3 mm. Female sex, low BMI, and low BSA remained significant predictors of DRA diameter < 2.3 mm.

Risk Factors Associated with Development and Persistence of Long COVID: A Cross-Sectional Study

BackgroundLong coronavirus disease (COVID) has been a social concern. Though patient characteristics associated with the development of long COVID are partially known, those associated with its persistence have not been identified. MethodsWe conducted a cross-sectional questionnaire survey of patients after COVID-19 recovery who visited the National Center for Global Health and Medicine between February 2020 and March 2021. Demographic and clinical data and data regarding the presence and duration of long COVID were obtained. We identified factors associated with the development and persistence of long COVID using multivariate logistic and linear regression analysis, respectively. ResultsWe analyzed 457 of 526 responses (response rate, 86.9%). The median age was 47 years, and 378 patients (84.4%) had mild disease in the acute phase. The number of patients with any symptoms after 6 and 12 months after onset or diagnosis were 120 (26.3%) and 40 (8.8%), respectively. Women were at risk for development of fatigue (odds ratio [OR]: 2.03, 95% confidence interval [CI]: 1.31-3.14), dysosmia (OR: 1.91, 95% CI: 1.24-2.93), dysgeusia (OR: 1.56, 95% CI: 1.02-2.39), and hair loss (OR: 3.00, 95% CI: 1.77-5.09) and for persistence of any symptoms (coefficient: 38.0, 95% CI: 13.3-62.8). Younger age and low body mass index were risk factors for developing dysosmia (OR: 0.96, 95% CI: 0.94-0.98 and OR: 0.94, 95% CI: 0.89-0.99, respectively) and dysgeusia (OR: 0.98, 95% CI: 0.96-1.00 and OR: 0.93, 95% CI: 0.88-0.98, respectively). ConclusionWe identified risk factors for the development and persistence of long COVID. Many patients suffer from long-term residual symptoms, even in mild cases.

Validation of a Feed Protocol in a Mouse Model That Mimics Marasmic Malnutrition

Host nutritional status directly interferes with immunity and/or susceptibility to infectious diseases. To understand the mechanisms behind this relationship, the use of animal models and feeding protocols is necessary. In the literature, studies reporting marasmic malnutrition in mice are not common. In this context, the objective of this study was to validate a feed methodology that mimics marasmic malnutrition, examining the nutritional, biochemical, and hematological status in BALB/c mice. Weaned BALB/c mice were or were not fed a Restricted diet (36.26% carbohydrate, 8.79% protein, 4.95% fat, and 7.62 kJ/100 g). Some malnourished mice underwent a refed process with a Control diet (65.93% carbohydrate, 24.18% protein, 9.89% fat, and 15.24 kJ/100 g). The nutritional status of the mice was evaluated through phenotypic markers and hematological and biochemical parameters. Our results showed that the Restricted diet was able to induce mild malnutrition in mice, resulting in mouse weight loss of 12%, which could be reversed after refeeding. Malnourished mice demonstrated slow body growth and low body mass index (BMI) values. Malnourished mice also showed physical and behavioral changes, a reduction of 47.5% in leukocyte counts and a 2-fold increase in cholesterol levels. In conclusion, our feeding protocol was able to generate mild malnutrition and cause changes in the nutritional status of mice that could be similar to those observed in marasmic malnutrition.

Study of spectrum of fungal isolates in the sputum of newly diagnosed pulmonary tuberculosis patients

Tuberculosis is a state of immunosupression which exposes the patients to further opportunistic pathogens like fungus. Methods: 102 newly diagnosed sputum positive pulmonary tuberculosis cases were enrolled. Significant fungal isolates were seen in 31/102 (30.4%) patients. Aspergillus spp. were isolated in 13/31(41.9%) of the positive fungal cultures while Candida spp. were isolated in 15/31 (48.4%). Low body mass index, duration of symptoms, haemoptysis, severity of radiological features and IgG Aspergillus antibodies were independent risk factors for positive fungal culture. Significant proportion of patients with PTB have fungal colonisation of their airways which can lead to poor clinical outcomes. Few easily ascertained clinical parameters can help the clinician to determine patients who are at a higher risk of fungal colonisation.

Plasma Exo-miRNAs Correlated with AD-Related Factors of Chinese Individuals Involved in Aβ Accumulation and Cognition Decline

Numerous studies have investigated the risk factors of Alzheimer’s disease (AD), however, AD- risk factors related miRNAs were rarely reported. In this study, AD- risk factor related miRNAs of 119 Chinese individuals (47 AD patients and 62 cognitively normal controls) were investigated. The results showed that education, tea consumption, leisure activity, and social connection were low Body Mass Index (BMI), depression, and smoking were potentially risk factors for AD patients. Moreover, we screened exosome microRNAs (miRNAs) for the aforementioned lifestyle-related factors. Canonical correlation analyses revealed that our clinical observations were correlated with the miRNA expression profile for education, depression, leisure activity, and social connection. Furthermore, we predicted the targets of differentially expressed miRNAs and found that many of them were reported to be involved in the generation and clearance of Amyloid-beta (Aβ), important molecules related to cognition, and disease-activated microglia response to AD. Our results indicated that certain education and depression factors can contribute to AD progression by modulating miRNA expression, implying that preventive interventions might alter AD progression in Chinese patients.

Association of accumulated number of underweight with occurrence of tuberculosis

Underweight might be a risk factor of tuberculosis (TB), but the association between duration of underweight and occurrence of TB is inconclusive. The objective of this study was to determine whether there is a difference in occurrence of TB according to the cumulative number of underweight in an intermediate TB burden country. The National Health Insurance database was used. Eligible subjects were individuals without history of TB before 2006, and who underwent national health examination between January 2009 and 31 December 2010. Included individuals in the analysis were followed until 31 December 2017. Accumulated number of underweight was defined as the number of times recorded as underweight during the national health examination over four consecutive years. The primary outcome of the study was newly diagnosed TB according to accumulated number of underweight. Among a study population of 2,396,434, TB was identified in 9,322 (3.89%) cases. A high accumulated number of underweight and low body mass index (BMI) level were significantly associated with occurrence of TB. This association remained consistent after adjusting for demographic factors and underlying diseases. In stratified analysis based on age, sex, diabetes (DM), hypertension (HTN), and waist circumference (WC) in metabolic syndrome (MS), the accumulated number of underweight was related consistently to occurrence of TB. A high accumulated number of underweight was associated with increased risk of TB.

Consequences of Zuspan Protocol Applications in Eclampsia Pregnant Women and Seizures

Backgraund: Magnesium sulfate is the preferred anticonvulsant in the prevention and control of eclamptic convulsions. The Zuspan Regime is one of the most popular protocols used. However, due to toxicity concerns, several low-dose regimens have been implemented, given the low body mass index of Asian women. In our hospital, Zuspan Protocol is generally applied. Objective: We aimed to compare the results, effectiveness and reliability of 6-hour and 12-hour intravenous (i.v) MgSO4 infusions in the Zuspan Protocol in our hospital. Methods and Materials: A total of 700 cases of eclampsia were examined and these cases were treated with the Zuspan Protocol. The patients in the first group received 6 hours of treatment (n: 400), while the second group (n: 300) received the 12-hour treatment with magnesium sulfate. Recurrent convulsion rates, maternal and perinatal results of both regimens were evaluated and compared using unpaired t-test and chi-square test, respectively, for continuous and categorical variables. Result: We detected 700 eclamptic cases among 50.620 births in our hospital during the 7-year working period and this rate was found as 80.5 % of 700 women were in the 19-30 age group. Despite the fact that MgSO4 was infused in 700 eclamptic pregnant women, the rate of seizures was found to be total 3.57 %. Conclusion: The 12-hour intravenous Zuspan Protocol was found to be more effective and more preventive and safer than the eclamptic seizure compared to the 6-hour Zuspan Protocol.