Prognostic value of the oxygenation index measured during mechanical ventilation and weaning. A retrospective cohort study.

The aim of this study was to investigate the predictive value of the ratio of oxygen saturation (ROX) index calculated during mechanical ventilation (MV) and the weaning period in evaluating readiness to weaning and the success of the spontaneous breathing trial (SBT), extubation, and mortality. We also compared the results of the ROX index calculated with partial arterial oxygen pressure (PaO2), arterial oxygen saturation (SaO2%), and probe oxygen saturation (SpO2%). In this retrospective cohort study, the ROX index was calculated by SpO2%, PaO2, and SaO2% separately using the ROX index formula (PaO2 or SaO2 or SpO2 /FiO2)/respiratory rate. ROX was calculated during the first three days of MV treatment and the weaning period daily (SBT). Positive end-expiratory pressure and peak inspiratory pressure values were also recorded during these measurements. These ROX values were used to analyze whether they predict weaning readiness, SBT, extubation failure (EF), and mortality. The study included 107 mechanically ventilated patients. Weaning could be tried in 64 (60%) of the 107 patients; 44 (69%) of the 64 patients succeeded, and extubation was performed. 19 (43%) of 44 patients had EF. ROX values calculated with PaO2 during MV and SBT predicted readiness to wean, EF, and mortality better than ROX values calculated with SaO2 and SpO2. ROX values calculated with PaO2 during the third day of MV had the highest sensitivity and specificity for EF (sensitivity: 81%, specificity: 70% for the ROX<11 value). The results of this study suggest that the calculation of ROX index, not only with SpO2% but also with arterial blood gas PaO2 and SaO2% values, may be helpful in predicting the weaning readiness evaluation, SBT, and extubation success and mortality. Further studies with more patients are necessary to verify and standardize these results.

Estimation of anti-diabetes drug metformin in Turkiye using wastewater-based epidemiology.

Metformin is the most commonly used drug for the treatment of type 2 diabetes (T2D), which is dramatically increasing due to factors such as increasing obesity, physical inactivity, and aging of the population. Metformin analysis was carried out in composite wastewater samples seasonally collected from wastewater treatment plants in 10 cities in 2019 and 2020 30 cities in 2021 in Turkiye. Metformin was measured in all wastewater samples, with an average concentration of 97.81 µg/l in 2019, 75.19 µg/l in 2020, and 69.13 µg/l in 2021. This study was utilized to predict metformin usage in different sociodemographic regions in Turkiye using a wastewater-based epidemiology (WBE) approach. As a result of the analysis, the average metformin consumption in Turkiye was estimated to be 22.2 ± 9.6 [1.9-63.8] g/d/1,000 persons (mean ± SD [range]). Furthermore, these estimates were compared with data for time, sociodemographic characteristics, and patient numbers. Assessing the correlation with estimates and the socioeconomic classes of the cities in question revealed that cities with high-income levels had the lowest metformin use rate. Finally, the study provides supporting data aiding the development of public health strategies for decreasing the overall load of T2D across Turkiye.

Method development, validation, and application for simultaneous determination of 56 new psychoactive substances in surface water by LC-MS/MS.

Despite preventive legislation, the popularity and consumption of new psychoactive substances (NPS) have been steadily increasing in recent years. This study provides a rapid and sensitive method for the quantitation and the detection of 56 NPS from surface water. Sample clean-up and pre-concentration were performed by solid-phase extraction (SPE) with Oasis HLB (6 cc/500 mg) cartridge. Following the chromatographic separation with Shim-pack FC-ODS column, the all substances were quantified by liquid chromatography-tandem mass spectrometry. The method was optimized and validated for all NPS. Despite the wide variety of physicochemical properties of the analytes, the recoveries for all compounds studied were in the range of 69-117%. The limit of quantitation (LOQ) ranging from 2.5 to 15 ng/L was reached for reliable and accurate quantification of analytes. The analytical method developed was successfully applied to the surface water samples. While synthetic cannabinoids were not detected, mephedrone from the synthetic cathinone group was detected under the LOQ. This novel method was expected to be a part of future environmental routine analyses as a satisfactory method.

Value of Rox Index to Predict Intubation and Intensive Care Unit Outcome in Patients with Respiratory Failure.

BACKGROUND: Recent literature suggests that the respiratory rate oxygenation (ROX) index may be a useful parameter in predicting intubation indication in hypoxemic patients. OBJECTIVE: In this study, we evaluated the accuracy of the ROX index in predicting intubation, length of stay in the ICU, and mortality in ICU patients with hypoxemic respiratory failure with and without hypercapnia. METHODS: Single-centre retrospective cohort study of 290 patients, with a preliminary diagnosis of respiratory failure, who were treated with low flow oxygen systems. Demographics, medical history, clinical, laboratory, treatment, and prognostic data were obtained from the electronic records of the hospital. The ROX index was calculated at the time of ICU admission. RESULTS: Thirty-seven percent of non-hypercapnic and 69% of hypercapnic patients were intubated (p:0.005). In hypercapnic patients, ROX: 6.9 had highest sensitivity (81%) and specificity (65%) values for intubation (p:0.005). In non-hypercapnic patients, ROX: 6.2 had the highest sensitivity (81%) and specificity (40%) values. While 11% of hypercapnic patients and 30% of non-hypercapnic patients were died (p:0.05), 22% of hypercapnic patients and 33% of non-hypercapnic patients stayed in the ICU longer than 14 days (p:0.044). The highest sensitivity and specificity values were found for mortality in hypercapnic patients; for ROX value of 5.94 (sensitivity:86%, specificity:61%) and for ICU stay longer than 14 days; for ROX value of 7.4 (sensitivity:71%, specificity:68%). CONCLUSION: Results of our study suggest that ROX index calculated during ICU admission can be helpful in predicting intubation indication and length of ICU stay in patients with respiratory failure and hypercapnia may influence the cutoff values.

A clinical comparison of dynamic contour tonometry versus Goldmann applanation tonometry.

BACKGROUND AND OBJECTIVE: To compare the intraocular pressures (IOP) obtained with dynamic contour tonometry (DCT) and Goldmann applanation tonometry (GAT) and to determine the dependency of both devices on corneal structure. PATIENTS AND METHODS: One hundred forty eyes of 70 patients were included. Cases with corneal pathologies, former glaucoma diagnosis, and systemic diseases were excluded. All eyes underwent measurements of central corneal thickness (CCT) and corneal curvature. IOP measurements were obtained with GAT and DCT. The agreement of measurements was statistically analyzed. RESULTS: The correlation of IOP values obtained with DCT and GAT was statistically significant. The mean DCT values were 0.46 ± 2.55 mm Hg higher than those of GAT, but this difference was statistically insignificant. Bland-Altman plots showed reasonable inter-method agreement between DCT and GAT measurements. GAT readings were significantly affected by CCT, but DCT measurements were affected by age and corneal curvature. CONCLUSION: DCT is a reliable method of assessing IOP and is less dependent on central corneal thickness. This new technology may be a promising step forward in the management of glaucoma. Further studies are required to validate these observations.